PERIODONTAL SPECIALISTS OF CLARKSTON
NPI 1548447576
Dentist - Periodontics in Clarkston, MI

Q: What is Periodontal Specialists Of Clarkston's NPI number?

The NPI number for Periodontal Specialists Of Clarkston is 1548447576. It was assigned to this organization in the NPPES registry on January 22, 2008.

Q: What is Periodontal Specialists Of Clarkston's specialty?

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

Active since January 22, 2008

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

NPPES record last updated: April 25, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Periodontal Specialists Of Clarkston NPPES

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

PERIODONTAL SPECIALISTS OF CLARKSTON (NPI 1548447576) is a healthcare organization registered as a periodontics in Clarkston, Michigan and active in the NPI registry since January 2008. The organization lists Suheil Michael Boutros, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1548447576

Entity TypeOrganization

Primary Taxonomy1223P0300X

Legal Business NamePERIODONTAL SPECIALISTS OF CLARKSTON

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

Phone(248) 625-1721

Fax(248) 625-5475

Organization SubpartNo

Authorized OfficialSuheil Michael BoutrosCeo/president · (810) 695-6444

Enumeration DateJanuary 22, 2008

Last NPPES UpdateApril 25, 2022

NPPES CertifiedApril 25, 2022

✔ NPI 1548447576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

License✔ Licensed in MI · 16909

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

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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.

PERIODONTAL SPECIALISTS OF CLARKSTON PC

Dentist (Periodontics)

6803 DIXIE HWY STE 1
CLARKSTON, MI 48346

Oakland County (248) 625-1721

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's NPI number?

The NPI number for Periodontal Specialists Of Clarkston is 1548447576. It was assigned to this organization in the NPPES registry on January 22, 2008.

Where is Periodontal Specialists Of Clarkston located?

Periodontal Specialists Of Clarkston 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'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 was last updated on April 25, 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.