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DR. GHANEM M. GHANNAM D.D.S.
NPI 1770612780
Dentist - Oral and Maxillofacial Surgery in Detroit, MI

Active since March 05, 2007PECOS Enrolled
5705 W VERNOR HWY, DETROIT, MI 48209(313) 842-3770 Get Directions Write a Review

NPPES record last updated: August 8, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Ghanem M. Ghannam D.d.s. NPPES

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

DR. GHANEM M. GHANNAM D.D.S. (NPI 1770612780) is an individual oral and maxillofacial surgery provider in Detroit, Michigan, licensed in Michigan (014082) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770612780
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. GHANEM M. GHANNAMCredential: D.D.S.
Location Address5705 W VERNOR HWYDetroit, MI 48209-2157
Mailing Address5705 W Vernor HwyDetroit, MI 48209-2157 · (313) 842-3770
Phone(313) 842-3770
Sole ProprietorNo
Enumeration DateMarch 5, 2007
Last NPPES UpdateAugust 8, 2024
NPPES CertifiedAugust 8, 2024
✔ NPI 1770612780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MI · 014082
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 ListedDentist · General PracticeTaxonomy 1223G0001X · License 014082 (MI)
5705 W VERNOR HWY, Detroit, MI 48209
Open in Google Maps ↗

Other Identifiers 1

Medicaid1692476MI

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ghanem M. Ghannam D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ghanem Ghannam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

G Ghannam D D S
Same address
Dental
5705 W VERNOR HWY
Detroit, MI 48209
  • Reassigned Medicare billing, Michigan enrollment
NPI 1255508800 (313) 842-3770

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48209 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

DR. ELHAM JAVIDAN-NEJAD DDS
Dentist
5705 W VERNOR HWY
DETROIT, MI 48209
Wayne County (313) 842-3770
VERNOR MEDICAL CENTER, PC
Clinic/Center (Primary Care)
5705 W VERNOR HWY
DETROIT, MI 48209
Wayne County (313) 841-0395
ZAINAB ZAINI DDS
Dentist
5705 W VERNOR HWY
DETROIT, MI 48209
Wayne County (313) 842-3771
G GHANNAM D D S
Clinic/Center (Dental)
5705 W VERNOR HWY
DETROIT, MI 48209
Wayne County (313) 842-3770
NORBERTO ALLENDE-JIMENEZ MD
General Practice
5705 W VERNOR HWY
DETROIT, MI 48209
Wayne County (313) 841-0395
DR. TALA MAHJOUB DDS
Dentist (General Practice)
5705 W VERNOR HWY
DETROIT, MI 48209
Wayne County (313) 842-3772
DR. DAVID GERARD SELUK D.D.S.
Dentist (General Practice)
5705 W VERNOR HWY
DETROIT, MI 48209
Wayne County (313) 842-3770
DR. MOUSA GHANNAM DMD
Dentist (General Practice)
5705 W VERNOR HWY
DETROIT, MI 48209
Wayne County (313) 842-3770

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 Ghanem Ghannam's NPI number?

The NPI number for Ghanem Ghannam is 1770612780. It was assigned to this individual provider in the NPPES registry on March 5, 2007.

Where is Ghanem Ghannam located?

Ghanem Ghannam practices at 5705 W Vernor Hwy, Detroit, MI 48209. The listed phone number is (313) 842-3770.

What is Ghanem Ghannam's specialty?

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

Is Ghanem Ghannam enrolled in Medicare?

Yes. Ghanem Ghannam is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ghanem Ghannam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ghanem Ghannam reassigns Medicare benefits to G Ghannam D D S (Detroit, MI). The 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 Ghanem Ghannam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ghanem Ghannam accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and Delta Dental of Michigan list Ghanem Ghannam 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 Ghanem Ghannam was last updated on August 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.