Michigan Oms P C

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MICHIGAN OMS P C

Practice address

6022 W Maple Rd Ste 405
West Bloomfield, MI 48322-4408

Phone

(248) 855-2006

Fax

(248) 855-0571

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas J Bournias, DDSNPI 1144202045

Title

President

Phone

(586) 228-9070

Specialties & licenses 1

Addresses

Other identifiers 11

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas James Bournias, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Clinton Township, MI
  • NPI 1144202045

  MI, Oral and Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Thomas Richard Bolten, D.D.S., MD

  • Oral and Maxillofacial Surgery (Dentist)
  • West Bloomfield, MI
  • NPI 1053545707

  MI

  Medicare reassignment Care Compare group
• Brian Cleland Murphy, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • West Bloomfield, MI
  • NPI 1861674137

  MI

  Medicare reassignment Care Compare group
• Jeffrey Stephen Topf, DDS,FACS

  • Oral and Maxillofacial Surgery (Dentist)
  • West Bloomfield, MI
  • NPI 1396727293

  MI

  Medicare reassignment
• Aaron Michael Pokorny, D.D.S, M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Rochester Hills, MI
  • NPI 1366589228

  Oral and Maxillofacial Surgery

  NPD (past)
• Gregg Lawrence Lurcott, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Denver, CO
  • NPI 1821042896

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1801906458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6022 W MAPLE RD STE 405",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224408",
            "telephone_number": "248-855-2006",
            "fax_number": "248-855-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6022 W MAPLE RD STE 405",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224408",
            "telephone_number": "248-855-2006",
            "fax_number": "248-855-0571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43900 Garfield Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480381137",
            "country_code": "US",
            "telephone_number": "586-228-9070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHIGAN OMS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "BOURNIAS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-228-9070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "2901020355",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3159052",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4067429",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2990516",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2990561",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2773480",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER BCBSM",
            "identifier": "970F31085",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "NB015573",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021382",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3203473",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2990552",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Healthcare Professionals PC
• Michigan Institute for Laparoscopic Surgery PC
• Michigan Institute of Sleep Disorders PLLC
• Michigan Interventional Pain Associates PLLC
• Michigan Interventional Pain Associates PLLC
• Michigan Orthopaedic Surgeons PLLC
• Michigan Pediatric ENT Associates, PLLC
• Michigan Radiology Services, P.C.
• Michigan Surgery Specialists P.C.
• Michigan Telemedicine Associates, P.C.

• All providers in West Bloomfield, MI
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.