Organization Active NPI

Alamat Oral & Maxillofacial Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Shelby Township, MI
National Provider Identifier
1265955082
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ALAMAT ORAL & MAXILLOFACIAL SURGERY PLLC
Practice address
51685 Van Dyke Ave
Shelby Township, MI 48316
Phone
(586) 924-2038
Fax
(586) 323-1644
NPI assigned
Jul 24, 2017
Last updated
Sep 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Authorized official

Name
Mrs. Katie White, R.N.
Title
Manager
Phone
(586) 924-2038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

51685 Van Dyke Ave
Shelby Township, MI 48316

Mailing address

51685 Van Dyke Ave
Shelby Township, MI 48316-4449
Phone (586) 924-2038

Other practice location 1

51685 Van Dyke Ave
Shelby Township, MI 48316
Phone (586) 924-2038

Other identifiers 3

IdentifierTypeStateIssuer
0E06779OtherMIBCBS GROUP PIN
5501882OtherMIBCBS DENTAL PIN
0503550OtherMIBCBS MEDICAL PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170929003257 MI Part B Supplier - Clinic/Group Practice 4789959776 Receives reassigned benefits from 2 practitioners
Practice locations: Shelby Township, MI

National Provider Directory

National Provider Directory
Tax ID family
Alamat Oral Surgery PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

51685 Van Dyke Ave
Shelby Township, MI 48316
Phone (586) 924-2038

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1265955082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51685 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483164449",
            "telephone_number": "586-924-2038",
            "fax_number": "586-323-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51685 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48316",
            "telephone_number": "586-924-2038",
            "fax_number": "586-323-1644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51685 Van Dyke Ave",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "48316",
            "country_code": "US",
            "telephone_number": "586-924-2038",
            "fax_number": "586-323-1644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALAMAT ORAL & MAXILLOFACIAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "586-924-2038",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PIN",
            "identifier": "0E06779",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DENTAL PIN",
            "identifier": "5501882",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDICAL PIN",
            "identifier": "0503550",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.