Individual provider Active NPI

Solomon K Pesis, DDS

  • General Practice Dentistry
  • Farmington Hills, MI
National Provider Identifier
1407820616
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12547 Issued in MI
Practice address
29224 W 8 Mile Rd
Farmington Hills, MI 48336-5500
Phone
(248) 478-1650
Fax
(248) 478-2166
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12547 MI Primary

Addresses

Primary practice location

29224 W 8 Mile Rd
Farmington Hills, MI 48336-5500

Mailing address

4180 Rodeo Dr
Milford, MI 48381-3767
Phone (248) 684-1420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150120002277 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4284691536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12547MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pesis Dental Group, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1407820616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 RODEO DR",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483813767",
            "telephone_number": "248-684-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29224 W 8 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365500",
            "telephone_number": "248-478-1650",
            "fax_number": "248-478-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESIS",
        "first_name": "SOLOMON",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.