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INSTITUTE OF JAW AND FACIAL SURGERY INC NPI 1689647018


NPI Information

NPI: 1689647018
Provider Name: INSTITUTE OF JAW AND FACIAL SURGERY INC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
4181 HOLIDAY ST NW
CANTON, OH
ZIP 44718
Phone: (330) 493-1605
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INSTITUTE OF JAW AND FACIAL SURGERY INC is an oral and maxillofacial surgery dentist in Canton, OH. 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. INSTITUTE OF JAW AND FACIAL SURGERY INC NPI is 1689647018. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4181 HOLIDAY ST NW
CANTON, OH
ZIP 44718-531
Phone: (330) 493-1605
Fax: (330) 493-9308

The provider's authorized official is Richard N Sundheimer .
The authorized official title is President and has the following contact phone number (330) 493-1605.

The enumeration date for this NPI number is 2/8/2006 and was last updated on 4/18/2012.


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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1U19505MEDICARE UPINOHIO
20733255MEDICAIDOHIO
3T48532MEDICARE UPINOHIO
40600433MEDICAIDOHIO
59279132MEDICARE PINOHIO
69279131MEDICARE PINOHIO
7T47925MEDICARE UPINOHIO
80524534MEDICAIDOHIO

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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