MEDICARE: SOLOMON PESIS DDS, DENTAL OUTREACH P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	19.027813	IL

General Provider Information

NPI Number	:	1245484286
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLOMON PESIS DDS, DENTAL OUTREACH P.C.

Provider Business Mailing Address
First Line	:	33533 W 12 MILE RD STE 150
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-5600
Country	:	US
Telephone Number	:	888-833-8441
Fax Number	:	888-330-4331

Provider Business Practice Location Address
First Line	:	8770 W BRYN MAWR AVE
Second Line	:	SUITE 1300
City	:	CHICAGO
State	:	IL
Zip	:	60631-3515
Country	:	US
Telephone Number	:	888-833-8441
Fax Number	:	888-330-4331

Authorized Official
Title or Position	:	DENTAL DIRECTOR
Name	:	DR. SOLOMON PESIS
Credential	:	DDS
Telephone Number	:	888-833-8441

Provider Enumeration Date	:	11/04/2008
Last Update Date	:	02/18/2026

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