Provider Type Icon

MONTGOMERY ORAL & FACIAL SURGERY NPI 1467695593


NPI Information

NPI: 1467695593
Provider Name: MONTGOMERY ORAL & FACIAL SURGERY
Classification: Clinic/Center - 261QS0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 21D2282946

Address:
4701 RANDOLPH RD
SUITE G10
ROCKVILLE, MD
ZIP 20852
Phone: (301) 468-0020
Get Directions

MONTGOMERY ORAL & FACIAL SURGERY is an oral and maxillofacial surgery clinic center in Rockville, MD. The provider is an oral and maxillofacial surgery clinic or center 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. MONTGOMERY ORAL & FACIAL SURGERY NPI is 1467695593. The provider is registered as an organization entity type.

The provider's business location address is:

4701 RANDOLPH RD
SUITE G10
ROCKVILLE, MD
ZIP 20852-257
Phone: (301) 468-0020

The provider's authorized official is Leonard A Merlo .
The authorized official title is Owner and has the following contact phone number (301) 468-0020.

The CLIA number assigned to this NPI record is 21D2282946 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/20/2009 and was last updated on 4/20/2009.


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
1261QS0112XClinic/CenterOral 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
1U56228MEDICARE UPIN
2691198MEDICARE PIN

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.