GREATER MICHIGAN ORAL SURGEONS & DENTAL IMPLANT CENTER
NPI 1902993819
Dentist - Oral and Maxillofacial Surgery in Flint, MI
About Greater Michigan Oral Surgeons & Dental Implant Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREATER MICHIGAN ORAL SURGEONS & DENTAL IMPLANT CENTER (NPI 1902993819) is a healthcare organization registered as an oral and maxillofacial surgery in Flint, Michigan and active in the NPI registry since October 2006. The organization lists Samantha A Kern, Credentialing & Billing, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 2
Other Identifiers 6
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Greater Michigan Oral Surgeons & Dental Implant Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Greater Michigan Oral Surgeons & Dental Implant Center, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Surgery And Implants, P.C.'s NPI number?
The NPI number for Great Lakes Oral Surgery And Implants, P.C. is 1902993819. It was assigned to this organization in the NPPES registry on October 10, 2006. The provider is doing business as Greater Michigan Oral Surgeons & Dental Implant Center. The provider was formerly known as Oral and Maxillofacial Surgery, P.C..
Where is Great Lakes Oral Surgery And Implants, P.C. located?
Great Lakes Oral Surgery And Implants, P.C. is located at 5417 Gateway Ctr, Flint, MI 48507. The listed phone number is (810) 424-0705.
What is Great Lakes Oral Surgery And Implants, P.C.'s specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Great Lakes Oral Surgery And Implants, P.C. enrolled in Medicare?
Yes. Great Lakes Oral Surgery And Implants, P.C. is registered in the Medicare PECOS enrollment system.
When is Great Lakes Oral Surgery And Implants, P.C.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Great Lakes Oral Surgery And Implants, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Oral Surgery, reassign their Medicare billing to Great Lakes Oral Surgery And Implants, P.C.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Great Lakes Oral Surgery And Implants, P.C. was last updated on August 28, 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.
# Greater Michigan Oral Surgeons & Dental Implant Center · NPI 1902993819
Oral and Maxillofacial Surgery organization in Flint, Michigan. Organization record, active in the CMS NPPES registry since October 10, 2006.
## Identity
- **NPI:** 1902993819 (Entity type: Organization)
- **Enumerated:** October 10, 2006
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **Legal business name:** Great Lakes Oral Surgery And Implants, P.c.
- **Also known as:** Oral and Maxillofacial Surgery, P.C. (Former Legal Business Name)
- **Organization subpart:** Yes (part of Great Lakes Oral Surgery And Implants, P.c.)
- **Authorized official:** Samantha Kern, CREDENTIALING & BILLING
## Practice location
- **Address:** 5417 GATEWAY CTR, Flint, MI 48507-3980
- **Phone:** (810) 424-0705 · **Fax:** (810) 424-0750
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Oral Surgery) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 28, 2024
- **Other identifiers:** Medicaid 2594587 (MI); Other 9752562480 (MI); Medicaid 4045904 (MI); and 3 more
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Source: [NPI Profile](https://npiprofile.com/npi/1902993819) · Data from the CMS NPPES public registry.