MICHIGAN ORAL AND MAXILLOFACIAL SURGEONS, P.C. (NPI# 1528008042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1528008042 |
Entity Type | Organization |
Organization Name | MICHIGAN ORAL AND MAXILLOFACIAL SURGEONS, P.C. |
Other Organization Name | DOCTORS DALBERT W. FEAR, JR, ROGER P. HITCHCOCK & WILLIAM D. BAXTER,JR |
Practice Address |
2058 S State St Suite 100 Ann Arbor MI 48104-4786 |
Practice Telephone | 7347696524 |
Practice Fax Number | 7347696743 |
Mailing Telephone | 7347696524 |
Mailing Fax Number | 7347696743 |
Enumeration Date | 2006-06-07 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. DALBERT W. FEAR JR. (VICE PRESIDENT) |
Authorized Official Telephone | 7347696524 |
Authorized Official Credential | DDS, MS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | BCBS GROUP NUMBER | 970H17622 | 01 |
MI | BCBS DENTAL GROUP # | J801610 | 01 |
Other Name | Type Code |
---|---|
Doctors Dalbert W. Fear, Jr, Roger P. Hitchcock & William D. Baxter,Jr | Doing Business As Name - Organization |
Street Address |
2058 S STATE ST SUITE 100 |
City | ANN ARBOR |
State | MI |
Zip Code | 48104-4786 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679049506 | Marcus Lewis | Physical Therapist | 2058 S State St, Ann Arbor, MI 48104-4786 | 2018-10-18 |
1154800860 | Kimberly Borys | Physical Therapist | 2058 S State St, Ann Arbor, MI 48104-4786 | 2018-08-13 |
1134667835 | Indira Moreno | Physical Therapist | 2058 S State St, Ann Arbor, MI 48104-4786 | 2017-02-02 |
1043601370 | Suzanne Gerhardt | Physical Therapist | 2058 S State St, Ann Arbor, MI 48104-4786 | 2015-02-09 |
1801287131 | Ann Kovacs | Physical Therapist | 2058 S State St, Ann Arbor, MI 48104-4786 | 2015-02-09 |
1609267921 | Catherine Thornton | Physical Therapist | 2058 S State St, Ann Arbor, MI 48104-4786 | 2015-02-09 |
1346646684 | Rachel Rebner | Physical Therapist | 2058 S State St, Ste 500, Ann Arbor, MI 48104-4786 | 2014-11-14 |
1083965958 | Andrew Squire | Physical Therapist | 2058 S State St, Suite 500, Ann Arbor, MI 48104-4786 | 2012-10-02 |
1629388764 | Anna Clark | Physical Therapist | 2058 S State St, Suite 500, Ann Arbor, MI 48104-4786 | 2010-10-07 |
1740474634 | Kortney Roof | Physical Therapist | 2058 S State St, Suite 205, Ann Arbor, MI 48104-4786 | 2007-09-04 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336603927 | Julie Corey | Counselor | 2604 Brockman Blvd, Ann Arbor, MI 48104 | 2019-01-28 |
1003301045 | Ann Arbor Pharmacy LLC | Pharmacy | 2418 E Stadium Blvd, Ann Arbor, MI 48104 | 2018-06-22 |
1811499304 | Melissa L Wright | Physical Therapist | 2850 S Industrial Hwy Suite 200, Ann Arbor, MI 48104 | 2018-03-01 |
1689180226 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3500 Washtenaw Ave Ste E3, Ann Arbor, MI 48104 | 2017-12-19 |
1861911547 | Jonathen Ross | Social Worker | 500 E. Washington St., Ste 100a, Ann Arbor, MI 48104 | 2017-09-14 |
1275058521 | Emily Lauren Hanna | Social Worker | 214 S. Main Street, Suite # 206, Ann Arbor, MI 48104 | 2017-08-08 |
1073035457 | Raynaldo Juaquin Valdez | Specialist/Technologist | 500 E. Hoover Ave, Ann Arbor, MI 48104 | 2017-07-07 |
1912436908 | Alison Nicole Tseng | Dentist | 2301 Platt Rd Ste 200, Ann Arbor, MI 48104 | 2017-06-05 |
1528593183 | Hillary Baldwin Steller, Lmsw,llc | Social Worker | 715-717 E. Huron St, Suite 2e, Ann Arbor, MI 48104 | 2017-04-20 |
1013360973 | Teresa Myers | Massage Therapist | 2230 Washtenaw Ave, Suite 101, Ann Arbor, MI 48104 | 2016-07-15 |
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Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568080414 | Shawn J Kim | Dentist | 425 E Washington St Apt 811, Ann Arbor, MI 48104-2060 | 2020-07-08 |
1396907051 | Paul Christian Lopez | Dentist | 2058 S State St Ste 100, Ann Arbor, MI 48104-4787 | 2008-06-25 |
1346409869 | Christopher Richard Sanker | Dentist | 2058 S. State Street, Suite 100, Ann Arbor, MI 48104 | 2008-06-09 |
1316167612 | Matthew Stephen Pinsky | Dentist | 3055 Plymouth Rd., Ann Arbor, MI 48105 | 2007-04-27 |
1417519331 | Dylan Starck | Dentist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2019-07-01 |
1841852860 | Aram Keteyian | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2019-06-29 |
1215391636 | Oded Nahlieli | Dentist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2016-04-12 |
1235535089 | Shadi Alzahrani | Dentist | 1500 E Medical Center Drive, Floor 1, Reception A, Room 1904, Ann Arbor, MI 48109-0312 | 2014-11-06 |
1972913382 | Paul Shivers | Dentist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2014-05-07 |
1316383979 | Mohamed Abdel Hakim | Dentist | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2013-05-21 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.