Healthcare Provider Details

I. General information

NPI: 1013812387
Provider Name (Legal Business Name): OAK STAR DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N MAIN ST STE 200
MILFORD MI
48381-1999
US

IV. Provider business mailing address

305 CURRY AVE
ROYAL OAK MI
48067-1907
US

V. Phone/Fax

Practice location:
  • Phone: 248-979-7191
  • Fax:
Mailing address:
  • Phone: 248-979-7191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ALEXA PERES
Title or Position: DENTIST
Credential: DDS
Phone: 248-979-7191