Osama Potres Kesto, DMD, MS

Primary specialty

DentistTaxonomy code 122300000X

License

2901601473 Issued in MI

Practice address

22972 Lahser Rd Ste 1
Southfield, MI 48033-4408

Phone

(248) 864-2500

NPI assigned

Jul 9, 2022

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

Other names 1

• Dr. Osama Imad Potres Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657324800000",
    "number": "1679207302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37525 HACKER DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104061",
            "telephone_number": "586-565-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22972 LAHSER RD STE 1",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334408",
            "telephone_number": "248-864-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESTO",
        "first_name": "OSAMA",
        "middle_name": "POTRES",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-09",
        "last_updated": "2022-07-09",
        "certification_date": "2022-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OSAMA",
            "last_name": "POTRES",
            "middle_name": "IMAD",
            "prefix": "DR.",
            "credential": "DMD, MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Southfield, MI
• Providers in Southfield, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.