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ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC NPI 1831264324


NPI Information

NPI: 1831264324
Provider Name: ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
7845 CARNEGIE BLVD
FORT WAYNE, IN
ZIP 46804
Phone: (260) 969-4105
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ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC is an oral and maxillofacial surgery dentist in Fort Wayne, IN. 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. ORAL & MAXILLOFACIAL SURGERY ASSOCIATES PC NPI is 1831264324. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7845 CARNEGIE BLVD
FORT WAYNE, IN
ZIP 46804
Phone: (260) 969-4105
Fax: (260) 969-4118

The provider's authorized official is Celeste C Sholl .
The authorized official title is Cda and has the following contact phone number (260) 423-2340.

The enumeration date for this NPI number is 11/21/2006 and was last updated on 7/9/2020.


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 SurgeryNo
2363L00000XNurse PractitionerNo
31223S0112XDentistOral 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
1200029030MEDICAIDINDIANA
26185590001OTHERINDIANANGS DME MAC
36185590001OTHERINDIANADME MAC

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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