NPIMap

Organization Active NPI

Northern Michigan Oral and Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Petoskey, MI
National Provider Identifier
1154483014
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2901013255 Issued in MI
Legal business name
NORTHERN MICHIGAN ORAL AND MAXILLOFACIAL SURGERY PC
Practice address
322 Bay St
Petoskey, MI 49770-2489
Phone
(231) 347-1601
NPI assigned
Dec 15, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. James Osetek, DMDNPI 1003892944
Title
Owner
Phone
(231) 347-1601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 2901013255 MI Primary

Addresses

Primary practice location

322 Bay St
Petoskey, MI 49770-2489

Mailing address

322 Bay St
Petoskey, MI 49770-2489
Phone (231) 347-1601

National Provider Directory

National Provider Directory

Locations

322 Bay St
Petoskey, MI 49770
Phone (231) 347-1601

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1154483014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 BAY ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702489",
            "telephone_number": "231-347-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 BAY ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702489",
            "telephone_number": "231-347-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MICHIGAN ORAL AND MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "OSETEK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-347-1601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901013255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.