Periodontal Specialists Group

Primary specialty

DentistTaxonomy code 122300000X

License

9095 Issued in MI

Legal business name

PERIODONTAL SPECIALISTS GROUP

Practice address

8619 West Grand River
Suite F
Brighton, MI 48116

Phone

(810) 227-7427

Fax

(810) 227-8248

NPI assigned

Feb 21, 2008

Last updated

Feb 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Frederick Silverston, DDS MS

Title

Partner

Phone

(810) 227-7427

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1770752925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8619 WEST GRAND RIVER",
            "address_2": "SUITE F",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "48116",
            "telephone_number": "810-227-7427",
            "fax_number": "810-227-8248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8619 WEST GRAND RIVER",
            "address_2": "SUITE F",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "48116",
            "telephone_number": "810-227-7427",
            "fax_number": "810-227-8248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL SPECIALISTS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "SILVERSTON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "810-227-7427",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "10031",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "14883",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "9095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.