Pradeep Andrew Kissoondial, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

017432 Issued in MI

Practice address

42051 Mound Rd
Sterling Heights, MI 48314-3143

Phone

(586) 323-7700

Fax

(586) 323-7707

NPI assigned

Oct 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial Surgery

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oakland Oral Surgery AssociatesGroup PAC ID 9436196235, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pkissoondial1134816@direct.hfhs.org

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.

• Oakland Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Sterling Heights, MI
  • NPI 1033299052
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548346232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42051 MOUND RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143143",
            "telephone_number": "586-323-7700",
            "fax_number": "586-323-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42051 MOUND RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143143",
            "telephone_number": "586-323-7700",
            "fax_number": "586-323-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSOONDIAL",
        "first_name": "PRADEEP",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "017432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Kingsbury, MA, LLPC
• Carina Kiriazis, PA-C
• Kirksey Home Care
• Alvin Kirma, DPT
• Chloe Kiryakoza
• Jessica Kistuline
• Julianna Kitter
• Janice B Kizy, LMSW
• Mazin Sabri Kizy, D.D.S.
• Nicholas Kizy, DDS

• Oral and Maxillofacial Surgery (Dentist) in Sterling Heights, MI
• Providers in Sterling Heights, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.