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RENAISSANCE ORAL SURGERY PC
NPI 1235325499
Dentist - Oral and Maxillofacial Surgery in Roseville, MI

Active since September 21, 2007
20805 E 12 MILE RD, STE 110, ROSEVILLE, MI 48066(586) 778-2100(586) 778-2422 Get Directions Write a Review

NPPES record last updated: October 1, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Renaissance Oral Surgery Pc NPPES

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

RENAISSANCE ORAL SURGERY PC (NPI 1235325499) is a healthcare organization registered as an oral and maxillofacial surgery in Roseville, Michigan and active in the NPI registry since September 2007. The organization lists Henry Bryan, President, as its authorized official.

NPPES Registry Identity

NPI1235325499
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameRENAISSANCE ORAL SURGERY PC
Location Address20805 E 12 MILE RD, STE 110Roseville, MI 48066
Mailing Address20805 E 12 Mile Rd, Ste 110Roseville, MI 48066 · (586) 778-2100 · Fax (586) 778-2422
Phone(586) 778-2100
Fax(586) 778-2422
Organization SubpartNo
Authorized OfficialHenry BryanPresident · (586) 778-2100
Enumeration DateSeptember 21, 2007
Last NPPES UpdateOctober 1, 2013
✔ NPI 1235325499 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.

Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X
Also ListedPlastic Surgery · Plastic Surgery Within the Head and NeckTaxonomy 2082S0099X
20805 E 12 MILE RD, Roseville, MI 48066
Open in Google Maps ↗

Other Identifiers 7

OtherP00230001MI · Medicare Provider
Medicare PINP00230001
Other975506164MI · Bc/bs Medicare Advantage
Other128744MI · Care Choices
Other2856MI · Golden Dental
Other975506164MI · Bc/bs Of Mi
OtherU33701MI · Hap

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Other Providers at the Same Location NPPES 4

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

HENRY GASSON BRYAN D.D.S.
Oral & Maxillofacial Surgery
20805 E 12 MILE RD, SUITE 110
ROSEVILLE, MI 48066
Macomb County (586) 778-2100
DIANA LIVIA MASTRONARDI D.D.S.
Dentist (General Practice)
20805 E 12 MILE RD
ROSEVILLE, MI 48066
Macomb County (586) 773-9660
J.L. COLON, DDS, PLLC
Dentist (General Practice)
20805 E 12 MILE RD, SUITE 100
ROSEVILLE, MI 48066
Macomb County (586) 773-9660
MICHELENE RILEY LEPCZYK D.D.S.
Dentist (General Practice)
20805 E 12 MILE RD, SUITE 100
ROSEVILLE, MI 48066
Macomb County (586) 773-9660

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 Renaissance Oral Surgery PC's NPI number?

The NPI number for Renaissance Oral Surgery PC is 1235325499. It was assigned to this organization in the NPPES registry on September 21, 2007.

Where is Renaissance Oral Surgery PC located?

Renaissance Oral Surgery PC is located at 20805 E 12 Mile Rd Ste 110, Roseville, MI 48066. The listed phone number is (586) 778-2100.

What is Renaissance Oral Surgery PC's specialty?

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

What insurance does Renaissance Oral Surgery PC accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Renaissance Oral Surgery PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Renaissance Oral Surgery PC was last updated on October 1, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.