GREAT LAKES ORAL AND MAXILLOFACIAL SURGERY P.C.
NPI 1760008528
Dentist - Oral and Maxillofacial Surgery in Petoskey, MI

Q: What is Great Lakes Oral And Maxillofacial 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 June 17, 2020

2325 SUMMIT PARK DR STE D, PETOSKEY, MI 49770(231) 487-1020 Get Directions Write a Review

NPPES record last updated: June 17, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Great Lakes Oral And Maxillofacial Surgery P.c. NPPES

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

GREAT LAKES ORAL AND MAXILLOFACIAL SURGERY P.C. (NPI 1760008528) is a healthcare organization registered as an oral and maxillofacial surgery in Petoskey, Michigan and active in the NPI registry since June 2020. The organization lists Robert Scott Sheperd, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1760008528

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameGREAT LAKES ORAL AND MAXILLOFACIAL SURGERY P.C.

Location Address2325 SUMMIT PARK DR STE DPetoskey, MI 49770-8774

Mailing Address2325 Summit Park Dr Ste DPetoskey, MI 49770-8774 · (231) 487-1020

Phone(231) 487-1020

Organization SubpartNo

Authorized OfficialRobert Scott SheperdCeo/president · (231) 487-1020

Enumeration DateJune 17, 2020

NPPES CertifiedJune 17, 2020

✔ NPI 1760008528 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.

2325 SUMMIT PARK DR STE D, Petoskey, MI 49770

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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 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.

DR. SEAN JOSEPH STRINGER D.D.S.

Dentist

2325 SUMMIT PARK DR STE D
PETOSKEY, MI 49770

Emmet County (231) 487-1020

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 Great Lakes Oral And Maxillofacial Surgery P.C.'s NPI number?

The NPI number for Great Lakes Oral And Maxillofacial Surgery P.C. is 1760008528. It was assigned to this organization in the NPPES registry on June 17, 2020.

Where is Great Lakes Oral And Maxillofacial Surgery P.C. located?

Great Lakes Oral And Maxillofacial Surgery P.C. is located at 2325 Summit Park Dr Ste D, Petoskey, MI 49770. The listed phone number is (231) 487-1020.

What is Great Lakes Oral And Maxillofacial Surgery P.C.'s specialty?

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

When was this NPI record last updated?

The NPPES record for Great Lakes Oral And Maxillofacial Surgery P.C. was last updated on June 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.