MICHIGAN ORAL AND MAXILLOFACIAL SURGEONS, P.C.


Address: 2058 S State St, Suite 100, Ann Arbor, MI 48104-4786
Phone: 7347696524

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI BCBS GROUP NUMBER 970H17622 01
MI BCBS DENTAL GROUP # J801610 01

Other Provider/Organization Names

Other Name Type Code
Doctors Dalbert W. Fear, Jr, Roger P. Hitchcock & William D. Baxter,Jr Doing Business As Name - Organization

Office Location

Street Address 2058 S STATE ST
SUITE 100
City ANN ARBOR
State MI
Zip Code 48104-4786

Providers in the same location

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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Providers in the same zip code

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 Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

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
Find all providers in ANN ARBOR

Competitor

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City ANN ARBOR
Zip Code 48104

Improve Information

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Dataset Information

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.

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