Active NPI
Petar Simoski, DDS
- Dentist
- Novi, MI
National Provider Identifier
1548992464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901601461
- Practice address
- 39555 W 10 Mile Rd Ste 306
Novi, MI 48375-2950 - Phone
- (248) 442-7305
- NPI assigned
- Jun 29, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901601461 | MI | Primary |
Addresses
Primary practice location
39555 W 10 Mile Rd Ste 306
Novi, MI 48375-2950
Mailing address
3594 Mildred Ave
Rochester Hills, MI 48309-4262
Phone (248) 296-9755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901601461 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656979200000",
"number": "1548992464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3594 MILDRED AVE",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483094262",
"telephone_number": "248-296-9755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39555 W 10 MILE RD STE 306",
"city": "NOVI",
"state": "MI",
"postal_code": "483752950",
"telephone_number": "248-442-7305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMOSKI",
"first_name": "PETAR",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-29",
"last_updated": "2022-07-05",
"certification_date": "2022-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901601461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.