Mark Anthony Azzopardi, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901013122 Issued in MI

Practice address

39595 W 10 Mile Rd
#107
Novi, MI 48375-2948

Phone

(248) 476-0800

Fax

(248) 476-5531

NPI assigned

Oct 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oakland Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Sterling Heights, MI
  • NPI 1033299052
  Medicare reassignment NPD
• Oakland Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Novi, MI
  • NPI 1437399870
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710063631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39595 W 10 MILE RD",
            "address_2": "#107",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752948",
            "telephone_number": "248-476-0800",
            "fax_number": "248-476-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39595 W 10 MILE RD",
            "address_2": "#107",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752948",
            "telephone_number": "248-476-0800",
            "fax_number": "248-476-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZOPARDI",
        "first_name": "MARK",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901013122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nasser Azeez, M.D.
• Maleehah Azom
• Hussein Azzam, MD
• Lara Azzi, MD
• Ashley Azzo
• B and S Service Corp PC (D.B.A. Oakland Surgical Associates)
• Latramese Monique Baber
• Mikayla Bable
• Jessica Baca
• Kylee Baca

• Oral and Maxillofacial Surgery (Dentist) in Novi, MI
• Providers in Novi, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.