HENRY FORD HEALTH ST. JOHN HOSPITAL – NPI #1376820605
Otolaryngology

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

HENRY FORD HEALTH ST. JOHN HOSPITAL is an otolaryngologist located in SAINT CLAIR SHORES, MI. NPPES has assigned the NPI number 1376820605 to HENRY FORD HEALTH ST. JOHN HOSPITAL on November 15, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Y00000X from the Health Care Provider Taxonomy code set, which is classified as Otolaryngology. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was last updated on May 19, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for HENRY FORD HEALTH ST. JOHN HOSPITAL below.

NPI Profile for
HENRY FORD HEALTH ST. JOHN HOSPITAL

NPI Number
1376820605
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
HENRY FORD HEALTH ST. JOHN HOSPITAL
Other name(s)
All associated names:
Doing Business As (dba)
Henry Ford St. John Hospital
Doing Business As (dba)
Lakeshore ENT Center
Primary location
21000 E 12 MILE RD STE 111
SAINT CLAIR SHORES, MI 48081-1156
Phone: (586) 779-7610 Fax: (586) 779-0031
Mailing address
PO BOX 670884
DETROIT, MI 48267-0884
Phone: Fax:
Organization Subpart
No
Authorized Official
KIMBERLY CEBALT
DIRECTOR
Phone: (313) 874-6764
Updated
Certification Date
May 19, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.