Columbus Oral & Maxillofacial Surgery PC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

052372 Issued in GA

Legal business name

COLUMBUS ORAL & MAXILLOFACIAL SURGERY PC

Practice address

4405 N Stadium Dr
Suite a
Columbus, GA 31909-1878

Phone

(706) 507-0901

Fax

(706) 507-0984

NPI assigned

May 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John R Scuba, DDSNPI 1811948771

Title

Owner

Phone

(706) 507-0901

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Richard Scuba, MD, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Columbus, GA
  • NPI 1811948771

  Oral and Maxillofacial Surgery

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1003023870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 N STADIUM DR",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319091875",
            "telephone_number": "706-507-0901",
            "fax_number": "706-507-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 N STADIUM DR",
            "address_2": "SUITE A",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319091878",
            "telephone_number": "706-507-0901",
            "fax_number": "706-507-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS ORAL & MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "SCUBA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-507-0901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN013256",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "GA",
            "license": "052372",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "GA",
            "license": "052372",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GA (M) GROUP",
            "identifier": "IP09476001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Columbus, GA
• Providers in Columbus, GA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.