Periodontal Specialists of Clarkston
NPI 1548447576ActiveOrganization· Dentist, Periodontics· Clarkston, MI
Dentist, Periodontics in Clarkston, Michigan, registered in NPPES in January 2008. The authorized official on file is Suheil Michael Boutros, DDS,MS, Ceo/President.
Overview
| NPI | 1548447576 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 22, 2008 |
| Last updated in NPPES | Apr 25, 2022 |
| Certified by provider | Apr 25, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Periodontics Primary | 1223P0300X | 16909 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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