Periodontal Specialists of Flint PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PERIODONTAL SPECIALISTS OF FLINT PC

Practice address

4252 S Linden Rd
Flint, MI 48507-2953

Phone

(810) 733-1890

Fax

(810) 733-3619

NPI assigned

Jul 25, 2013

Last updated

Jul 25, 2013By 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

Suheil M Boutros, DDS, MS

Title

President

Phone

(810) 695-6444

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William D Beck, D.D.S.

  • Periodontics
  • Flint, MI
  • NPI 1700836103
  NPD (past)
• Courtney Berger, RDH

  • Dental Hygienist
  • Flint, MI
  • NPI 1841020971
  NPD (past)

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1932541455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8185 HOLLY RD",
            "address_2": "SUITE 19",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392444",
            "telephone_number": "810-695-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4252 S LINDEN RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072953",
            "telephone_number": "810-733-1890",
            "fax_number": "810-733-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL SPECIALISTS OF FLINT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "BOUTROS",
        "authorized_official_first_name": "SUHEIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-695-6444",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Maria Perez
• Kaitlin Perez
• Luis Augusto Perez, D.D.S.,M.S.,P.C.
• Raul Perez, LHAS
• Troy Perez, SST
• Tiara Lauryn Perkins, B.A.P.S.Y.
• Patricia A. Perrine, FNP
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04504)
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04310)
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04588)

• Periodontics in Flint, MI
• Providers in Flint, MI by specialty
• Periodontics in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; 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.