NPIMap

Organization Active NPI

Oral & Maxillofacial Surgeons Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Wauseon, OH
National Provider Identifier
1013680925
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ORAL & MAXILLOFACIAL SURGEONS INC
Practice address
725 S Shoop Ave Ste G01
Wauseon, OH 43567-1702
Phone
(419) 517-2100
NPI assigned
Jul 27, 2021
Organization subpart
Yes
Parent organization
ORAL & MAXILLOFACIAL SURGEONS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Authorized official

Name
Patrick J McCabe, DDS
Title
President
Phone
(419) 517-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

725 S Shoop Ave Ste G01
Wauseon, OH 43567-1702

Mailing address

4646 Nantuckett Dr Ste a
Toledo, OH 43623-3194
Phone (419) 517-2100

Other names 1

  • Harbor Light Oral & Maxillofacial Surgeons Inc Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205001344 OH Part B Supplier - Clinic/Group Practice 2062305691 Receives reassigned benefits from 1 practitioner
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Toledo, OH; Wauseon, OH; Bowling Green, OH

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Oral Maxillofacial Surg4 organizations share this tax ID, including this one
Part of
Oral Maxillofacial Surg

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1850 Eastgate Rd
Ste A
Toledo, OH 43614
Phone (419) 385-5743

4210 W Sylvania Ave
Toledo, OH 43623
Phone (206) 412-8208

Practitioners & affiliated clinicians

Practitioners 2

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": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1013680925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 NANTUCKETT DR STE A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233194",
            "telephone_number": "419-517-2100",
            "fax_number": "419-517-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE STE G01",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "419-517-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL & MAXILLOFACIAL SURGEONS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORAL & MAXILLOFACIAL SURGEONS INC",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "MCCABE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-517-2100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor Light Oral & Maxillofacial Surgeons Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wauseon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.