Provider Type Icon

COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY PSC NPI 1922480250


NPI Information

NPI: 1922480250
Provider Name: COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY, PSC

Doing Business As: COMMONWEALTH ORAL SURGERY

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
6520 GLENRIDGE PARK PL
SUITE 7
LOUISVILLE, KY
ZIP 40222
Phone: (502) 423-7822
Get Directions

COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY, PSC is an oral and maxillofacial surgery dentist in Louisville, KY. 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. COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY, PSC NPI is 1922480250. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Commonwealth Oral Surgery.

The provider's business location address is:

6520 GLENRIDGE PARK PL
SUITE 7
LOUISVILLE, KY
ZIP 40222-455
Phone: (502) 423-7822
Fax: (502) 423-7830

The provider's authorized official is Timothy Acord .
The authorized official title is Owner, President and has the following contact phone number (502) 423-7822.

The enumeration date for this NPI number is 6/23/2015 and was last updated on 6/23/2015.


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
1204E00000XOral & Maxillofacial Surgery8588KENTUCKYNo
21223S0112XDentistOral and Maxillofacial Surgery8588KENTUCKYYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.