NPIMap

Organization Active NPI

Affiliated Oral & Maxillofacial Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Glendale, AZ
National Provider Identifier
1013023928
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
5950 Issued in AZ
Legal business name
AFFILIATED ORAL & MAXILLOFACIAL SURGEONS PC
Practice address
5750 W Thunderbird
H-850
Glendale, AZ 85306
Phone
(602) 938-0880
Fax
(602) 547-0528
NPI assigned
Aug 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles G Bode, DMDNPI 1649375106
Title
Oral Surgeon
Phone
(602) 938-0880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 2579 AZ
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 5950 AZ Primary

Addresses

Primary practice location

5750 W Thunderbird
H-850
Glendale, AZ 85306

Mailing address

5750 W Thunderbird
H-850
Glendale, AZ 85306
Phone (602) 938-0880

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013023928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD",
            "address_2": "H-850",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85306",
            "telephone_number": "602-938-0880",
            "fax_number": "602-547-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD",
            "address_2": "H-850",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85306",
            "telephone_number": "602-938-0880",
            "fax_number": "602-547-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED ORAL & MAXILLOFACIAL SURGEONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BODE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "602-938-0880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "2579",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "5950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.