South Shore Oms PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SOUTH SHORE OMS PC

Practice address

2135 Monroe St
Dearborn, MI 48124-2922

Phone

(313) 561-0400

NPI assigned

Sep 17, 2026

Organization subpart

Yes

Parent organization

SOUTH SHORE OMS PCAs reported in NPPES

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

Authorized official

Name

Michaela Muniz

Title

VP, Payor Relations

Phone

(469) 324-3242

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1437061306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242922",
            "telephone_number": "313-561-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242922",
            "telephone_number": "313-561-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE OMS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH SHORE OMS PC",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "MUNIZ",
        "authorized_official_first_name": "MICHAELA",
        "authorized_official_title_or_position": "VP, PAYOR RELATIONS",
        "authorized_official_telephone_number": "469-324-3242"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• South Dearborn Pharmacy,Inc (south dearborn pharmacy)
• Abigail Channing Southard, MSN, CNM, C-EFM
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• Southeast Michigan Interventional Pain Specialists
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• Oral and Maxillofacial Surgery (Dentist) in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.