REGENTS OF THE UNIVERSITY OF MICHIGAN DENTAL FACULTY ASSOCIATES (NPI# 1528370434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528370434 |
| Entity Type | Organization |
| Organization Name | REGENTS OF THE UNIVERSITY OF MICHIGAN DENTAL FACULTY ASSOCIATES |
| Other Organization Name | DENTAL FACULTY ASSOCIATES |
| Practice Address |
1011 N University Ave Ann Arbor MI 48109-1078 |
| Practice Telephone | 7347633311 |
| Practice Fax Number | 7647635142 |
| Mailing Telephone | 7347633311 |
| Mailing Fax Number | 7647635142 |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |
| Authorized Official Name | PETER J POLVERINI (DEAN SCHOOL OF DENTISTRY) |
| Authorized Official Telephone | 7347633311 |
| Authorized Official Credential | DDS MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 2901016970 | MI | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| DENTAL FACULTY ASSOCIATES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386899805 | Regents of The University of Michigan Dental Faculty Associates | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2008-11-25 |
| 1932279882 | Regents of The University of Michigan Dental Faculty Associates | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2006-11-08 |
| Street Address |
1011 N UNIVERSITY AVE |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48109-1078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952388514 | Thomas S Marshall | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2005-12-26 |
| 1225655921 | Jae Young Han | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2020-06-29 |
| 1568085264 | Curtis Richard Herzog | Dentist | 1011 N University Ave, Department of Oral and Maxillofacial Surgery, Ann Arbor, MI 48109 | 2020-05-28 |
| 1205459039 | David Jarvie | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2020-05-27 |
| 1295357895 | Richard Klarck | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2020-05-18 |
| 1841811817 | Alexis Daniels | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2020-05-01 |
| 1114548112 | Carissa Choong | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2020-04-30 |
| 1285255281 | Ramandeep Kaur | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2020-04-30 |
| 1861012296 | Jade Cook | Dentist | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2020-04-27 |
| 1396379335 | Heather Marie Baughman | Student in an Organized Health Care Education/Training Program | 1011 N University Ave, Ann Arbor, MI 48109-1078 | 2020-02-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558987024 | Albert Byun | Student in an Organized Health Care Education/Training Program | 1500 E.medical Center Dr., 1h247, Ann Arbor, MI 48109 | 2020-06-22 |
| 1851914931 | Nadine Ibrahim | Student in an Organized Health Care Education/Training Program | 1500 E. Medical Center Drive, Spc 5312, Taubman Center, 1st Floor, Room 1903, Ann Arbor, MI 48109 | 2020-05-22 |
| 1568083350 | Tucker Zimmer | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Dr, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-03 |
| 1144841099 | Jessica Moore Meves | Student in an Organized Health Care Education/Training Program | 1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, MI 48109 | 2020-05-01 |
| 1710522297 | Xiaoyuan Hu | Specialist/Technologist | Obl 2150, 1402 Washington Hts, Ann Arbor, MI 48109 | 2019-11-08 |
| 1376192401 | Regina Kay Freeman | Clinical Nurse Specialist | 4726 Cardiovascular Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109 | 2019-09-11 |
| 1477114155 | William Philip Saunders IIi | Student in an Organized Health Care Education/Training Program | 300 N Ingalls Building, Rm Ni4co6, Ann Arbor, MI 48109 | 2019-06-24 |
| 1093290447 | Teresa H Lyden | Speech-Language Pathologist | 1500 E. Medical Center Dr., Spc 5312, 1904 Tc, Otolaryngology-head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1649755091 | Anna Grace Hardenbergh | Speech-Language Pathologist | 1500 E. Medical Center Drive Tc 1904, Otolaryngology Head and Neck Surgery, Ann Arbor, MI 48109 | 2018-10-02 |
| 1548754609 | Amy Wu | Pediatrics | 1500 East Medical Center Drive., Medical Professional Bldg. D-3238, Ann Arbor, MI 48109 | 2018-06-21 |
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| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558472332 | Richard F Scott Dds Ms PC | Oral & Maxillofacial Surgery | 203 S Zeeb Road, Suite 101, Ann Arbor, MI 48103 | 2006-08-31 |
| 1710949953 | Robert Harry Burke | Oral & Maxillofacial Surgery | 2260 S Huron Pkwy, Ann Arbor, MI 48104-5151 | 2006-04-04 |
| 1932207214 | Richard Frank Scott | Oral & Maxillofacial Surgery | 203 S Zeeb Road, Suite 101, Ann Arbor, MI 48103-8324 | 2006-09-20 |
| 1255442042 | Norbert Edward Fernandez | Oral & Maxillofacial Surgery | 203 S Zeeb Road, Suite 101, Ann Arbor, MI 48103 | 2006-08-31 |
| 1467487694 | Regents of The University of Michigan | Oral & Maxillofacial Surgery | 1500 East Medical Center Drive, B1 Floor University Hospital Rm B204, Ann Arbor, MI 48109-0018 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760900120 | Cynthia A Rider Dmd Pllc | Oral & Maxillofacial Surgery | 2545 Spring Arbor Road, Suite 202, Jackson, MI 49203 | 2017-09-06 |
| 1881792786 | James W Lepczyk | Oral & Maxillofacial Surgery | 31100 Telegraph, Suite 100, Bingham Farms, MI 48025 | 2006-09-21 |
| 1922115633 | Nick Leone | Oral & Maxillofacial Surgery | 28018 Harper Avenue, St Clair Shores, MI 48081 | 2006-08-25 |
| 1598772626 | Oral & Maxillofacial Surgery Associates of Western Michigan Plc | Oral & Maxillofacial Surgery | 2140 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4785 | 2006-08-02 |
| 1831113125 | Jeffery Mcfadden | Oral & Maxillofacial Surgery | 33111 W. Seven Mile Rd., Livonia, MI 48152 | 2006-07-27 |
| 1215950100 | William S Bloom | Oral & Maxillofacial Surgery | 11300 East Thirteen Mile Road, Warren, MI 48093 | 2006-07-25 |
| 1609809250 | Richard Peter Bartling | Oral & Maxillofacial Surgery | 3011 Abigail Ln, Midland, MI 48640 | 2006-07-08 |
| 1497728380 | Brian H Cohen | Oral & Maxillofacial Surgery | 2120 Monroe St, Dearborn, MI 48124-2943 | 2006-02-10 |
| 1659355063 | Donald Gary Wolford | Oral & Maxillofacial Surgery | 22811 Mack Ave, L1, St Clair Shores, MI 48080-2021 | 2005-11-30 |
| 1518949742 | Gregory M Nielsen | Oral & Maxillofacial Surgery | 26111 Woodward Ave, Huntington Woods, MI 48070-1330 | 2005-11-15 |
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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.