GRAND TRAVERSE ORAL SURGERY, P.C.
NPI 1003095605
Dentist - Oral and Maxillofacial Surgery in Traverse City, MI

Q: What is Grand Traverse Oral Surgery, P.C.'s NPI number?

The NPI number for Grand Traverse Oral Surgery, P.C. is 1003095605. It was assigned to this organization in the NPPES registry on October 31, 2007.

Q: What is Grand Traverse Oral Surgery, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since October 31, 2007

12776 S WEST BAY SHORE DR, TRAVERSE CITY, MI 49684(231) 946-3512(231) 946-1908 Get Directions Write a Review

NPPES record last updated: March 19, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Grand Traverse Oral Surgery, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND TRAVERSE ORAL SURGERY, P.C. (NPI 1003095605) is a healthcare organization registered as an oral and maxillofacial surgery in Traverse City, Michigan and active in the NPI registry since October 2007. The organization lists Susan J. Schlueter, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1003095605

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameGRAND TRAVERSE ORAL SURGERY, P.C.

Location Address12776 S WEST BAY SHORE DRTraverse City, MI 49684-5451

Mailing Address12776 S West Bay Shore DrTraverse City, MI 49684-5451 · (231) 946-3512 · Fax (231) 946-1908

Phone(231) 946-3512

Fax(231) 946-1908

Organization SubpartNo

Authorized OfficialSusan J. SchlueterOffice Manager · (231) 946-3512

Enumeration DateOctober 31, 2007

Last NPPES UpdateMarch 19, 2008

✔ NPI 1003095605 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

12776 S WEST BAY SHORE DR, Traverse City, MI 49684

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Other Identifiers 1

Other0P21110MI · Medicare Group #

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTHWAY AND HALL ORTHODONTICS PLLC

Dentist (Orthodontics and Dentofacial Orthopedics)