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SUMMIT ORAL & MAXILLOFACIAL SURGERY PC
NPI 1811066129
Dentist - Oral and Maxillofacial Surgery in Warren, MI

Active since November 08, 2006CLIA Certified · 5 labs
29427 RYAN RD, WARREN, MI 48092(586) 755-9340(586) 755-9341 Get Directions Write a Review

NPPES record last updated: September 14, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Summit Oral & Maxillofacial Surgery Pc NPPES

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

SUMMIT ORAL & MAXILLOFACIAL SURGERY PC (NPI 1811066129) is a healthcare organization registered as an oral and maxillofacial surgery in Warren, Michigan and active in the NPI registry since November 2006. The organization holds 5 active CLIA laboratory certificates and lists Jane M Windisch, Billing Specialist, as its authorized official.

NPPES Registry Identity

NPI1811066129
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameSUMMIT ORAL & MAXILLOFACIAL SURGERY PC
Location Address29427 RYAN RDWarren, MI 48092-2203
Mailing Address29425 Ryan RdWarren, MI 48092-2203 · (586) 755-9340 · Fax (586) 755-9341
Phone(586) 755-9340
Fax(586) 755-9341
Organization SubpartNo
Authorized OfficialJane M WindischBilling Specialist · (586) 755-9340
Enumeration DateNovember 8, 2006
Last NPPES UpdateSeptember 14, 2009
✔ NPI 1811066129 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.
29427 RYAN RD, Warren, MI 48092
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Other Identifiers 2

Other0E07680MI · Medicare Ptan
Other970E076800MI · Bc

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

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Summit Oral & Maxillofacial Surgery Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Summit Oral & Maxillofacial Surgery PC, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

David Coviak, D.D.S., M.D.
Oral Surgery
NPI 1164829438
29427 RYAN RD
Warren, MI 48092
(586) 755-9340
✔ PECOS✔ Accepts MedicareSame address
Nicolette Essian, DMD
Oral and Maxillofacial Pathology
NPI 1184240640
29427 RYAN RD
Warren, MI 48092
(586) 755-9340
✔ PECOS✔ Accepts MedicareSame address
John Hackenberger, DDS
Maxillofacial Surgery
NPI 1790730406
29427 RYAN RD
Warren, MI 48092
(586) 755-9340
✔ PECOS✔ Accepts MedicareSame address
Michael Kraemer, DMD, MD
Maxillofacial Surgery
NPI 1366480238
29427 RYAN RD
Warren, MI 48092
(586) 755-9340
✔ PECOS✔ Accepts MedicareSame address
Arshi Lehal, MD
Maxillofacial Surgery
NPI 1720341886
29427 RYAN RD
Warren, MI 48092
(586) 755-9340
✔ PECOS✔ Accepts MedicareSame address
Gregory Thomas, DDS, MS
Maxillofacial Surgery
NPI 1912947227
29427 RYAN RD
Warren, MI 48092
(586) 755-9340
✔ PECOSSame address
Claude Lerose, D.D.S.
Maxillofacial Surgery
NPI 1831536861
20675 MACK AVE
Grosse Pointe Woods, MI 48236
(313) 885-8344
✔ PECOS✔ Accepts Medicare9.4 mi
Rosolino Sclafani, DDS,MD
Oral Surgery
NPI 1467663294
7815 E JEFFERSON AVE SUITE 2B
Detroit, MI 48214
(313) 499-4775
✔ PECOS✔ Accepts Medicare12 mi

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

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2128454

Summit Oral & Maxillofacial Surgery · Warren, MI
Active · expires Mar 29, 2027
CLIA Number23D2128454
Laboratory TypePractitioner Other
Certificate Effective DateMarch 30, 2025
Certificate Expiration DateMarch 29, 2027
Laboratory DirectorGregory J. Thomas
Laboratory Phone(586) 755-9340
Laboratory LocationSummit Oral & Maxillofacial Surgery29427 Ryan Road, Warren, MI 48092
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2128451

Summit Oral & Maxillofacial Surgery · Macomb, MI
Active · expires Mar 29, 2027
CLIA Number23D2128451
Laboratory TypePractitioner Other
Certificate Effective DateMarch 30, 2025
Certificate Expiration DateMarch 29, 2027
Laboratory DirectorGregory J. Thomas
Laboratory Phone(586) 755-9340
Laboratory LocationSummit Oral & Maxillofacial Surgery15286 Wellington Center Blvd, Macomb, MI 48044
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2128452

Summit Oral & Maxillofacial Surgery · Grosse Pointe Woods, MI
Active · expires Mar 29, 2027
CLIA Number23D2128452
Laboratory TypePractitioner Other
Certificate Effective DateMarch 30, 2025
Certificate Expiration DateMarch 29, 2027
Laboratory DirectorGregory J. Thomas
Laboratory Phone(586) 755-9340
Laboratory LocationSummit Oral & Maxillofacial Surgery20675 Mack Avenue, Grosse Pointe Woods, MI 48236
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2128455

Summit Oral & Maxillofacial Surgery · Rochester Hills, MI
Active · expires Mar 29, 2027
CLIA Number23D2128455
Laboratory TypePractitioner Other
Certificate Effective DateMarch 30, 2025
Certificate Expiration DateMarch 29, 2027
Laboratory DirectorGregory J. Thomas
Laboratory Phone(586) 755-9340
Laboratory LocationSummit Oral & Maxillofacial Surgery305 Barclay Circle Suite 1000, Rochester Hills, MI 48307
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2160552

Summit Oral And Maxillofacial Surgery · Washington Township, MI
Active · expires Jan 13, 2027
CLIA Number23D2160552
Laboratory TypePractitioner Other
Certificate Effective DateJanuary 14, 2025
Certificate Expiration DateJanuary 13, 2027
Laboratory DirectorGregory J. Thomas
Laboratory Phone(586) 755-9340
Laboratory LocationSummit Oral And Maxillofacial Surgery12150 30 Mile Road Suite 202, Washington Township, MI 48095
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Summit Oral & Maxillofacial Surgery PC's NPI number?

The NPI number for Summit Oral & Maxillofacial Surgery PC is 1811066129. It was assigned to this organization in the NPPES registry on November 8, 2006.

Where is Summit Oral & Maxillofacial Surgery PC located?

Summit Oral & Maxillofacial Surgery PC is located at 29427 Ryan Rd, Warren, MI 48092. The listed phone number is (586) 755-9340.

What is Summit Oral & Maxillofacial Surgery PC's specialty?

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

Is Summit Oral & Maxillofacial Surgery PC enrolled in Medicare?

Yes. Summit Oral & Maxillofacial Surgery PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Summit Oral & Maxillofacial Surgery PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Summit Oral & Maxillofacial 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. The largest specialties are Maxillofacial Surgery (5), Oral Surgery (2) and Oral and Maxillofacial Pathology (1). Of these, 6 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Summit Oral & Maxillofacial Surgery PC hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Summit Oral & Maxillofacial Surgery PC accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and UnitedHealthcare list Summit Oral & Maxillofacial 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 Summit Oral & Maxillofacial Surgery PC was last updated on September 14, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.