KEYSTONE ORAL AND MAXILLOFACIAL SURGERY PC (NPI# 1427457191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427457191 |
| Entity Type | Organization |
| Organization Name | KEYSTONE ORAL AND MAXILLOFACIAL SURGERY PC |
| Practice Address |
36975 Utica Rd Suite 106 Clinton Township MI 48036-1685 |
| Practice Telephone | 5862262801 |
| Practice Fax Number | 5862261519 |
| Mailing Telephone | 5862262801 |
| Mailing Fax Number | 5862261519 |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-10-27 |
| Authorized Official Name | MR. ANTHONY E KASPER (OWNER) |
| Authorized Official Telephone | 5869140093 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2901017390 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS BLUE SHIELD | 0E04308 | 01 |
| Street Address |
36975 UTICA RD SUITE 106 |
| City | CLINTON TOWNSHIP |
| State | MI |
| Zip Code | 48036-1685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831190701 | Macomb Family Services, Inc. | Psychologist | 36975 Utica Rd, Suite 103, Clinton Township, MI 48036-1685 | 2005-08-02 |
| 1396216057 | Edward Fields Iv | Counselor | 36975 Utica Rd, Clinton Township, MI 48036-1685 | 2018-12-06 |
| 1326599036 | Macomb Family Services, Inc | Counselor | 36975 Utica Rd, Suite 104, Clinton Township, MI 48036-1685 | 2016-10-18 |
| 1689923039 | Jennifer Ann Pantaleo | Social Worker | 36975 Utica Rd, Clinton Township, MI 48036-1685 | 2012-08-30 |
| 1356629422 | Sharon Elizabeth Thompson | Counselor | 36975 Utica Rd, Clinton Township, MI 48036-1685 | 2011-07-24 |
| 1144519547 | Robyn N Lentz | Social Worker | 36975 Utica Rd, Suite 100, Clinton Township, MI 48036-1685 | 2011-04-06 |
| 1396913893 | Ascension Medical Resources Group | Family Medicine | 36975 Utica Rd, Suite 102, Clinton Township, MI 48036-1685 | 2008-02-19 |
| 1649338534 | Lise A Shirtz | Psychologist | 36975 Utica Rd, Suite 103, Clinton Township, MI 48036-1685 | 2006-12-05 |
| 1083780498 | Owen Pfaendtner | Social Worker | 36975 Utica Rd, Suite 104, Clinton Township, MI 48036-1685 | 2006-11-28 |
| 1649341850 | Renee Cannon | Counselor | 36975 Utica Rd, Suite 104, Clinton Township, MI 48036-1685 | 2006-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043728918 | Joseph John Memminger IIi | Pathology | 23885 Denton St Ste B, Clinton Township, MI 48036 | 2018-01-13 |
| 1124563267 | Melinda Fiends | Social Worker | 42950 Stepnitz, Clinton Township, MI 48036 | 2016-12-28 |
| 1689119729 | The Salvation Army Harbor Light Macomb | Substance Abuse Rehabilitation Facility | 42950 Stepnitz Drive, Clinton Township, MI 48036 | 2016-12-28 |
| 1639573033 | Mycare Health Center | Clinic/Center | 43740 Groesbeck, Clinton Township, MI 48036 | 2014-10-14 |
| 1427368992 | Prestigious Transportation | Non-emergency Medical Transport (VAN) | 22931 N.nunneley Apt. 203, Clinton Township, MI 48036 | 2010-10-18 |
| 1649413436 | Robert B Hengehold | Pharmacist | 37165 Groesbeck Hwy., Clinton Twp., MI 48036 | 2009-04-09 |
| 1548408461 | Rodolfo Sia Yapchai | Internal Medicine | 37900 Saddle Lane, Clinton Twp, MI 48036 | 2009-01-30 |
| 1811135775 | Anthony Frank Balcerzak | Rehabilitation Counselor | 38516 N Gratiot Avenue, Clinton Twp, MI 48036 | 2009-01-30 |
| 1508034661 | Laurie J Church | Counselor | 22800 Hall Rd Ste 240, Clinton Township, MI 48036 | 2008-02-12 |
| 1912128182 | Phyllis Ann Billings-mcneil | Social Worker | 38251 Groesbeck Highway, Clinton Twp, MI 48036 | 2007-05-02 |
| Find all providers in zip 48036 | ||||
| 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 |
|---|---|---|---|---|
| 1962969634 | Garfield Road Dental - 1 | Dentist | 41781 Garfield Rd, Clinton Township, MI 48038-1964 | 2019-02-28 |
| 1144202045 | Nicholas James Bournias | Dentist | 43900 Garfield Rd Ste 103, Clinton Township, MI 48038-1137 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568080414 | Shawn J Kim | Dentist | 425 E Washington St Apt 811, Ann Arbor, MI 48104-2060 | 2020-07-08 |
| 1760008528 | Great Lakes Oral and Maxillofacial Surgery P.C. | Dentist | 2325 Summit Park Dr Ste D, Petoskey, MI 49770-8774 | 2020-06-17 |
| 1477903904 | Abed Yakan | Dentist | 2700 Martin Luther King Jr. Blvd., 358, Detroit, MI 48208-2576 | 2016-06-15 |
| 1811378508 | Christopher Niquette | Dentist | 2119 64th Street Sw, Byron Center, MI 49315-4931 | 2015-06-18 |
| 1528446069 | Douglas David Orzel | Dentist | 9021 N Rodgers Ct Se Ste A, Caledonia, MI 49316-7650 | 2015-05-17 |
| 1013321165 | Raymond James Hanna | Dentist | 3766 Elder Rd S, West Bloomfield, MI 48324-2534 | 2014-06-17 |
| 1831536861 | Claude Charles Lerose Jr. | Dentist | 20675 Mack Ave, Grosse Pointe Woods, MI 48236 | 2013-05-31 |
| 1821433566 | Curtis Cardon | Dentist | 5957 Harvey St Ste 200, Norton Shores, MI 49444-9737 | 2013-05-08 |
| 1043568694 | Nick Leone Dds PC | Dentist | 28018 Harper Ave., St. Clair Shores, MI 48081-1562 | 2012-08-29 |
| 1770848129 | Bradley Dental | Dentist | 21635 Ryan Rd, Warren, MI 48091-2788 | 2012-07-11 |
| Find all providers with the same taxonomy | ||||
| City | CLINTON TOWNSHIP |
| Zip Code | 48036 |
Please comment or provide details below to improve the information on KEYSTONE ORAL AND MAXILLOFACIAL SURGERY PC.
| 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.