Justin Pisano, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901022858 Issued in MI

Practice address

429 NW 11TH St
Apt 6
Oklahoma City, OK 73103-3927

Phone

(734) 604-1843

NPI assigned

Nov 19, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ou Medicine Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1649794157
  NPD (past)

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1477927085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 SHERMAN ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062918",
            "telephone_number": "734-604-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 NW 11TH ST",
            "address_2": "APT 6",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731033927",
            "telephone_number": "734-604-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANO",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "1318",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901022858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camryn Coleen Pique
• Bilal Hussain Piracha, M.D
• Gail A Piraino, OTA
• Dustin Pirtle, BHCM II
• Jessica Pirtle
• Olga Carmen Elise Pischedda, LPC
• Mark Siegfried Pitambersingh, CPO, LPO
• Maheswaran Pitchaimuthu, M.D.,
• Chase Andrew Pitchford
• Linda Suzanne Pitchford, APRN-CNS

• Oral and Maxillofacial Surgery (Dentist) in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.