Individual provider Active NPI

Jacob Pesis

  • General Practice Dentistry
  • Farmington Hills, MI
National Provider Identifier
1952358863
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11339 Issued in MI
Practice address
29224 W 8 Mile Rd
Farmington Hills, MI 48336-5500
Phone
(248) 478-1650
NPI assigned
May 27, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11339 MI Primary

Addresses

Primary practice location

29224 W 8 Mile Rd
Farmington Hills, MI 48336-5500

Mailing address

28880 Creek Bend Dr
Farmington Hills, MI 48331-2600

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141230001252 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9537126883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11339MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Pesis Dental Group, P.C. General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952358863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28880 CREEK BEND DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483312600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29224 W 8 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365500",
            "telephone_number": "248-478-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESIS",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "11339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.