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CHARLESTON ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES LLC NPI 1538636964


NPI Information

NPI: 1538636964
Provider Name: CHARLESTON ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES LLC

Other Name: OMSA

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 42D2082247

Address:
2320 COSGROVE AVE
CHARLESTON, SC
ZIP 29405
Phone: (843) 554-5003
Get Directions

CHARLESTON ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES LLC is an oral and maxillofacial surgery dentist in Charleston, SC. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. CHARLESTON ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES LLC NPI is 1538636964. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Omsa.

The provider's business location address is:

2320 COSGROVE AVE
CHARLESTON, SC
ZIP 29405-644
Phone: (843) 554-5003
Fax: (843) 745-0003

The provider's authorized official is Michael Porter .
The authorized official title is Owner and has the following contact phone number (214) 728-4858.

The CLIA number assigned to this NPI record is 42D2082247 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/24/2018 and was last updated on 5/19/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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