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

Q: 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.

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: August 09, 2026.

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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 ›

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.

Other Providers at the Same Location NPPES 7

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

DR. DAVID SCOTT COVIAK D.D.S., M.D.

Dentist (Oral and Maxillofacial Surgery)