RENAISSANCE ORAL SURGERY PC
NPI 1235325499
Dentist - Oral and Maxillofacial Surgery in Roseville, MI
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
Specialties & Licenses 3
Other Identifiers 7
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Renaissance Oral Surgery Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Renaissance Oral Surgery PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Is Renaissance Oral Surgery PC enrolled in Medicare?
Yes. Renaissance Oral Surgery PC is registered in the Medicare PECOS enrollment system.
When is Renaissance Oral Surgery PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Renaissance Oral Surgery PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Maxillofacial Surgery) reassigns their Medicare billing to Renaissance Oral Surgery PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Renaissance Oral Surgery Pc · NPI 1235325499
Oral and Maxillofacial Surgery organization in Roseville, Michigan. Organization record, active in the CMS NPPES registry since September 21, 2007.
## Identity
- **NPI:** 1235325499 (Entity type: Organization)
- **Enumerated:** September 21, 2007
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **Organization subpart:** No
- **Authorized official:** Henry Bryan, PRESIDENT
## Practice location
- **Address:** 20805 E 12 MILE RD, STE 110, Roseville, MI 48066
- **Phone:** (586) 778-2100 · **Fax:** (586) 778-2422
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Maxillofacial Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 1, 2013
- **Other identifiers:** Other P00230001 (MI); Medicare PIN P00230001; Other 975506164 (MI); and 4 more
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Source: [NPI Profile](https://npiprofile.com/npi/1235325499) · Data from the CMS NPPES public registry.