PERIODONTAL SPECIALISTS OF CLARKSTON PC
NPI 1225774789
Dentist - Periodontics in Clarkston, MI

Active since May 09, 2022
6803 DIXIE HWY STE 1, CLARKSTON, MI 48346(248) 625-1721(248) 625-5475 Get Directions Write a Review

NPPES record last updated: May 9, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Periodontal Specialists Of Clarkston Pc NPPES

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

PERIODONTAL SPECIALISTS OF CLARKSTON PC (NPI 1225774789) is a healthcare organization registered as a periodontics in Clarkston, Michigan and active in the NPI registry since May 2022. The organization lists Pam Strader, Insurance Coordinator, as its authorized official.

NPPES Registry Identity

NPI1225774789
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NamePERIODONTAL SPECIALISTS OF CLARKSTON PC
Location Address6803 DIXIE HWY STE 1Clarkston, MI 48346-5101
Mailing Address6803 Dixie Hwy Ste 1Clarkston, MI 48346-5101 · (248) 625-1721 · Fax (248) 625-5475
Fax(248) 625-5475
Organization SubpartNo
Authorized OfficialPam StraderInsurance Coordinator · (248) 625-1721
Enumeration DateMay 9, 2022
NPPES CertifiedApril 25, 2022
✔ NPI 1225774789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
6803 DIXIE HWY STE 1, Clarkston, MI 48346

Other Identifiers 1

Other1548447576MI · Fee For Service

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

Dentist (Periodontics)
6803 DIXIE HWY STE 1
CLARKSTON, MI 48346

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Periodontal Specialists Of Clarkston PC's NPI number?

The NPI number for Periodontal Specialists Of Clarkston PC is 1225774789. It was assigned to this organization in the NPPES registry on May 9, 2022.

Where is Periodontal Specialists Of Clarkston PC located?

Periodontal Specialists Of Clarkston PC is located at 6803 Dixie Hwy Ste 1, Clarkston, MI 48346. The listed phone number is (248) 625-1721.

What is Periodontal Specialists Of Clarkston PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Periodontal Specialists Of Clarkston PC was last updated on May 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.