JOHN P OMALLEY DMD PA NPI 1558426874

NPI Information

  • NPI: 1558426874
  • Provider Name: JOHN P OMALLEY DMD PA
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 2007 RANDOLPH ROAD
    CHARLOTTE, NC
    ZIP 28207
  • Phone: (704) 374-1221

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NPI Details

JOHN P OMALLEY DMD PA is an oral and maxillofacial surgery dentist in Charlotte, NC. 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. JOHN P OMALLEY DMD PA NPI is 1558426874. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2007 RANDOLPH ROAD
CHARLOTTE, NC
ZIP 28207
Phone: (704) 374-1221
Fax: (704) 344-0834

The provider's authorized official is John Patrick Omalley .
The authorized official title is President and has the following contact phone number (704) 374-1221.

The enumeration date for this NPI number is 12/27/2006 and was last updated on 3/4/2008.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery3852NORTH CAROLINAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
196521OTHERBCBS
2T63783MEDICARE UPIN
3241028MEDICARE PINNORTH CAROLINA

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: 11/21/2025

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