Peter J Polverini
DDS, DMSC | Dentist | 53+ years Exp
1011 N University Ave, Ann Arbor
Michigan, 48109-1078
734-763-6933 734-763-5142
Maps & DirectionsPeter J Polverini is a Ann Arbor, Michigan based Dentist with
53 years of experience in
Dentistry. He completed his graduation from
Other in 1973. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Peter J Polverini is
2901016040 for Oral and Maxillofacial Pathology in Michigan. His current practice location is
1011 N University Ave, Ann Arbor. Patients can reach him at
734-763-6933.
Peter J Polverini is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Peter J Polverini speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Peter J Polverini |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DDS, DMSC |
| Experience: | 53+ years |
| Medical School Attended: | Other |
| Graduation Year: | 1973 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 1011 N University Ave, Ann Arbor,
Michigan, 48109-1078 |
| Phone: | 734-763-6933 |
| Fax: | 734-763-5142 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 9436112802 |
| Enrollment ID: | I20041105001051 |
| NPI Number: | 1699808857 |
| NPI Enumeration Date: | 14 Mar, 2007 |
| NPI Last Update On: | 29 Jan, 2020 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Peter J Polverini are as mentioned below.
| License Number | Specialization | State | Status | |
| 2901016040 | Oral and Maxillofacial Pathology | Michigan | Primary | |
| 2901016040 | Dentistry | Michigan | Secondary | |
| 2901016040 | Pathology | Michigan | Secondary | |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Peter J Polverini is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Regents Of The University Of Michigan Oral Pathology (2466414685) | 3 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Peter J Polverini such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 4504373 | Medicaid | Michigan | |
| 4070694 | Medicaid | Michigan | |
| 195816845 | Other | Michigan | BCBS OF MI MED SURGICAL |
| 2667583 | Medicaid | Ohio | |
| 4874042 | Medicaid | Michigan | |
| D160400 | Other | Michigan | BCBS OF MI DENTAL |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 5700 Southwyck Blvd,
Toledo, Ohio |
| Zip: | 43614-1509 |
| Phone Number: | 800-288-8325 |
| Fax Number: | 419-866-5453 |
Patients can reach Peter J Polverini at
1011 N University Ave, Ann Arbor, Michigan or can
call to book an appointment on 734-763-6933.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.