NPIMap

Organization Active NPI

St. Clair Oral and Maxillofacial Surgery PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Richmond, MI
National Provider Identifier
1295627115
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
ST. CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC
Doing business as
St. Clair Oral and Maxillofacial Surgery PLLC
Practice address
36610 Heritage Dr
Richmond, MI 48062-1937
Phone
(586) 727-6800
Fax
(586) 727-6880
NPI assigned
Jul 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Dr. Nicholas James Bournias, DDS
Title
Owner/Surgeon
Phone
(248) 882-3195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

36610 Heritage Dr
Richmond, MI 48062-1937

Mailing address

36610 Heritage Dr
Richmond, MI 48062-1937
Phone (586) 727-6800

Other names 1

  • St. Clair Oral and Maxillofacial Surgery PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Clair Oms PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

36610 Heritage Dr
Richmond, MI 48062
Phone (586) 727-6800

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1295627115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36610 HERITAGE DR",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480621937",
            "telephone_number": "586-727-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36610 HERITAGE DR",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480621937",
            "telephone_number": "586-727-6800",
            "fax_number": "586-727-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLAIR ORAL AND MAXILLOFACIAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "BOURNIAS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/SURGEON",
        "authorized_official_telephone_number": "248-882-3195",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Clair Oral and Maxillofacial Surgery PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.