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CARDINAL ORAL & MAXILLOFACIAL SURGERY ASSOCIATES NPI 1114462496


NPI Information

NPI: 1114462496
Provider Name: CARDINAL ORAL & MAXILLOFACIAL SURGERY ASSOCIATES
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
870 DUNLAWTON AVE
SUITE 210
PORT ORANGE, FL
ZIP 32127
Phone: (386) 756-2580
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CARDINAL ORAL & MAXILLOFACIAL SURGERY ASSOCIATES is an oral and maxillofacial surgery dentist in Port Orange, FL. 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. CARDINAL ORAL & MAXILLOFACIAL SURGERY ASSOCIATES NPI is 1114462496. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

870 DUNLAWTON AVE
SUITE 210
PORT ORANGE, FL
ZIP 32127-274
Phone: (386) 756-2580
Fax: (386) 756-2333

The provider's authorized official is Sameer N. Hate .
The authorized official title is Owner and has the following contact phone number (386) 756-2580.

The enumeration date for this NPI number is 12/22/2016 and was last updated on 12/22/2016.


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 SurgeryDN15831FLORIDAYes

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
167275OTHERFLORIDABLUE CROSS BLUE SHIELD

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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