Ionia Oral Surgery | |
5238 W St Joe Hwy Suite 2 Lansing MI 48917-4085 | |
(517) 323-1000 | |
(517) 886-5566 |
Full Name | Ionia Oral Surgery |
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Speciality | Dentist |
Location | 5238 W St Joe Hwy, Lansing, Michigan |
Authorized Official Name and Position | Jeffrey E Persico (OWNER) |
Authorized Official Contact | 5173498383 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ionia Oral Surgery 4201 Okemos Rd Okemos MI 48864-3200 Ph: (517) 349-8383 | Ionia Oral Surgery 5238 W St Joe Hwy Suite 2 Lansing MI 48917-4085 Ph: (517) 323-1000 |
NPI Number | 1881797983 |
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Provider Enumeration Date | 09/06/2006 |
Last Update Date | 05/05/2015 |
Medicare PECOS PAC ID | 0547349458 |
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Medicare Enrollment ID | O20080505000086 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881797983 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Provider Name | John S Faber |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1487757563 PECOS PAC ID: 3971682881 Enrollment ID: I20080505000106 |
Provider Name | Jeffrey E Persico |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1437252509 PECOS PAC ID: 0345329256 Enrollment ID: I20080505000122 |
Provider Name | Ezio Francesco Novelli |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1558622712 PECOS PAC ID: 6406162973 Enrollment ID: I20180628002127 |
Provider Name | Igor Makovey |
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Provider Type | Practitioner - Maxillofacial Surgery |
Provider Identifiers | NPI Number: 1730440983 PECOS PAC ID: 6507171444 Enrollment ID: I20190606002402 |
Provider Name | Andrew Mark Baker |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1295148880 PECOS PAC ID: 2264747252 Enrollment ID: I20220728001929 |
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