Organization Active NPI

Rochester Hills Oms, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester Hills, MI
National Provider Identifier
1366745119
Registry record updated Nov 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ROCHESTER HILLS OMS, P.C.
Practice address
1205 W University Dr
Rochester Hills, MI 48307-1864
Phone
(248) 651-4202
NPI assigned
Dec 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2018

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

Authorized official

Name
Mrs. Lisa Marie Obry
Title
Office Manager
Phone
(248) 651-4202

Specialties & licenses 1

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

Addresses

Primary practice location

1205 W University Dr
Rochester Hills, MI 48307-1864

Mailing address

1205 W University Dr
Rochester Hills, MI 48307-1864
Phone (248) 651-4202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120820000025 MI Part B Supplier - Clinic/Group Practice 3173779527 Receives reassigned benefits from 3 practitioners
Practice locations: Rochester Hills, MI; Warren, MI

National Provider Directory

National Provider Directory

Locations

1460 Walton Blvd
Ste 10
Rochester Hills, MI 48309
Phone (248) 651-4202

1205 W University Dr
Rochester Hls, MI 48307
Phone (248) 651-4202

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541116800000",
    "number": "1366745119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 W UNIVERSITY DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071864",
            "telephone_number": "248-651-4202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 W UNIVERSITY DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071864",
            "telephone_number": "248-651-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCHESTER HILLS OMS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2018-11-02",
        "status": "A",
        "authorized_official_last_name": "OBRY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-651-4202",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.