Jason G Souyias, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2901019200 Issued in MI

Practice address

1175 Thomas Edison Dr
Port Huron, MI 48060-8500

Phone

(810) 987-1400

Fax

(810) 987-1349

NPI assigned

May 14, 2007

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 26, 2013 through Aug 26, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Peridontic Associates of Port Huron PLLC

  • Periodontics
  • Port Huron, MI
  • NPI 1760804983
  NPD (past) Authorized official
• Periodontic Associates of Port Huron

  • Periodontics
  • Port Huron, MI
  • NPI 1962783399
  NPD (past)

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1205042785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 THOMAS EDISON DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608500",
            "telephone_number": "810-987-1400",
            "fax_number": "810-987-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 THOMAS EDISON DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480608500",
            "telephone_number": "810-987-1400",
            "fax_number": "810-987-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUYIAS",
        "first_name": "JASON",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901019200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Snuggs
• Jennifer Snyder, RN
• Darouny Ann Sonsynath, PHARM.D
• Sonus-USA, Inc.
• Bridgette Sorrells
• Karen Ann Spagnoli, RN
• Jason Sparks
• Anna Christine Sparling-Jamison, PT
• Tanja Spencer, LMSW, ACSW
• Katelynn Sperry

• Periodontics in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.