Michigan Periodontics & Implants

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

2901017676 Issued in MI

Legal business name

MICHIGAN PERIODONTICS & IMPLANTS

Doing business as

Mi Perio PC

Practice address

3058 Metro Pkwy
Suite 110
Sterling Heights, MI 48310-3671

Phone

(586) 709-4210

NPI assigned

Nov 14, 2016

Organization subpart

No

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

Authorized official

Name

Bassam Kinaia, DDS MS

Title

DDS Ms

Phone

(248) 953-7676

Specialties & licenses 1

Addresses

Other names 1

• MI PERIO PC Doing business as

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1629510227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3058 METRO PKWY",
            "address_2": "SUITE 110",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483103671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3058 METRO PKWY",
            "address_2": "SUITE 110",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483103671",
            "telephone_number": "586-709-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN PERIODONTICS & IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "KINAIA",
        "authorized_official_first_name": "BASSAM",
        "authorized_official_title_or_position": "DDS MS",
        "authorized_official_telephone_number": "248-953-7676",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MI",
            "license": "2901017676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MI PERIO PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Periodontics in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.