NPIMap

Organization Active NPI

Oral Surgery Associates of Lansing PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lansing, MI
National Provider Identifier
1881797983
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ORAL SURGERY ASSOCIATES OF LANSING PC
Practice address
5238 W St Joe Hwy
Suite 2
Lansing, MI 48917-4085
Phone
(517) 323-1000
Fax
(517) 886-5566
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Dr. Jeffrey E Persico, DMDNPI 1437252509
Title
Owner
Phone
(517) 349-8383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

5238 W St Joe Hwy
Suite 2
Lansing, MI 48917-4085

Mailing address

4201 Okemos Rd
Okemos, MI 48864-3200
Phone (517) 349-8383

Other names 1

  • Ionia Oral Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080505000086 MI Part B Supplier - Clinic/Group Practice 0547349458 Receives reassigned benefits from 6 practitioners
Practice locations: Okemos, MI; Lansing, MI; Grand Rapids, MI; Ionia, MI; East Lansing, MI

National Provider Directory

National Provider Directory

Locations

2240 S State Rd
Ionia, MI 48846
Phone (616) 523-9000

5238 W St Joe Hwy
Ste 2
Lansing, MI 48917
Phone (517) 323-1000

4201 Okemos Rd
Okemos, MI 48864
Phone (517) 349-8383

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1881797983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 OKEMOS RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643200",
            "telephone_number": "517-349-8383",
            "fax_number": "517-349-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5238 W ST JOE HWY",
            "address_2": "SUITE 2",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174085",
            "telephone_number": "517-323-1000",
            "fax_number": "517-886-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY ASSOCIATES OF LANSING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "PERSICO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-349-8383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ionia Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.