Healthcare Provider Details

I. General information

NPI: 1952223034
Provider Name (Legal Business Name): S. PASTERNAK, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44201 DEQUINDRE RD
TROY MI
48085-1117
US

IV. Provider business mailing address

34477 FONTANA DR
STERLING HEIGHTS MI
48312-5777
US

V. Phone/Fax

Practice location:
  • Phone: 248-964-5000
  • Fax:
Mailing address:
  • Phone: 586-770-0612
  • Fax: 248-829-3634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE PASTERNAK
Title or Position: PROVIDER/OWNER
Credential: DDS, MD
Phone: 586-770-0612