Sean E Pack, DDS MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901022038 Issued in MI

Practice address

325 W Lake Lansing Rd
East Lansing, MI 48823-8524

Phone

(517) 337-9759

Fax

(517) 337-8156

NPI assigned

Jul 6, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid Michigan Oral Surgery PCGroup PAC ID 3274504881, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spack92772@direct.metrohealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mid Michigan Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • East Lansing, MI
  • NPI 1174516413
  Medicare reassignment Care Compare group NPD
• Mid Michigan Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Charlotte, MI
  • NPI 1861650095
  NPD
• The Metrohealth System

  dba Metrohealth Medical Center

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1700828852
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1083901425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238524",
            "telephone_number": "517-337-9759",
            "fax_number": "517-337-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W LAKE LANSING RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238524",
            "telephone_number": "517-337-9759",
            "fax_number": "517-337-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "SEAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901022038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelyn Ann Owczarzak Kowal, OD
• Katherine Elizabeth Owen
• Edward Oxer, PH.D./LICENSED PSYCH
• Matthew Oxie
• Chelsea Elizabeth Ozuch, MA, CCC-SLP/L
• Sydney Alexis Padgett
• Jenna Paek
• Wendy Elizabeth Page -Echols, D.O
• William Holding Page-Echols, D.O
• Palazzolo Therapy Services LLC

• Oral and Maxillofacial Surgery (Dentist) in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.