Organization
OAKLAND ORAL SURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK F MOORES DDS (ORAL AND MAXILLOFACIAL SURGEON)
(734) 427-3366
Entity
Organization
Contact information
Practice address
31646 SCHOOLCRAFT RD, LIVONIA, MI 48150-1819
(734) 427-3366
(734) 427-0407
Mailing address
31646 SCHOOLCRAFT RD, LIVONIA, MI 48150-1819
(734) 427-3366
(734) 427-0407
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
JM16423
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0P13950
MEDICARE GROUP PTAN
MI
01
—
P13950001
MEDICARE INDIVIDUAL PTAN
MI
01
—
P13950003
MEDICARE INDIVIDUAL PTAN
MI
01
—
P13950004
MEDICARE INDIVIDUAL PTAN
MI
Enumeration date
02/25/2009
Last updated
02/25/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up