Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Peter J Polverini, DDS, DMSC

Individual provider Dentist · NPI 1699808857

Peter J Polverini, DDS, DMSC is a Maxillofacial Surgery in Ann Arbor, Michigan. Qualified in 1973, 53 years ago. Practices with Regents of the University of Michigan Oral Pathology, a 4-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
53
Licensed in
MI
In the registry since
2007
Specialties on file
3
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1011 N University Ave
Ann Arbor, MI 48109-1078
Phone: (734) 763-6933
Fax: (734) 763-5142
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Pathology Dentistry (primary) Taxonomy 1223P0106X · Licence 2901016040 (MI)
Dentist Taxonomy 122300000X · Licence 2901016040 (MI)
Anatomic Pathology & Clinical Pathology Physician Taxonomy 207ZP0102X · Licence 2901016040 (MI)

Record details

NPI number1699808857
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS , DMSC
Sole proprietorYes
NPI enumeratedMarch 14, 2007
Last updated in NPPESJanuary 29, 2020
Certification dateJanuary 29, 2020
Mailing address5700 Southwyck Blvd, Toledo, OH 43614-1509

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Medical schoolOTHER
Graduated 1973 (53 years in practice)
Group practice Regents Of The University Of Michigan Oral Pathology — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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