OrganizationActive
South Shore Oms PC
NPI 1861122871 · Oral and Maxillofacial Surgery Clinic/Center · Brownstown Twp, MI
Provider details
- NPI number
- 1861122871
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kelly Doherty, Administrative(734) 479-2990
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
19249 Allen Rd
Brownstown Twp, MI 48183-1189
Phone: (734) 479-2990
Fax: (734) 479-2991
Street-level locationGet directions
Mailing address
19249 Allen Rd
Brownstown Twp, MI 48183-1189
Registry dates
- Enumerated
- 2022-06-13
- Last updated
- 2022-06-13
- Certified
- 2022-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.