Oasis Oral Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS038152 Issued in PA

Legal business name

OASIS ORAL SURGERY LLC

Practice address

9501 Roosevelt Blvd
Suite 101
Philadelphia, PA 19114-1025

Phone

(215) 904-8951

NPI assigned

Jan 6, 2012

Organization subpart

No

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

Authorized official

Name

Bryant Jones

Title

Owner

Phone

(215) 904-8951

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1023388196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD",
            "address_2": "SUITE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141025",
            "telephone_number": "215-904-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 ROOSEVELT BLVD",
            "address_2": "SUITE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141025",
            "telephone_number": "215-904-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OASIS ORAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRYANT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-904-8951"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS038152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102496758",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Ann Oalickal, DO
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• Oasis Dental
• Oasis Infusion Center PC
• Oasis of Compassion Home Care
• Jamaine Oates Sr.
• Desmond Oathes, PH.D.
• Giftty Eseoisa Obadan, DO
• Bolanle Obafemi, PHARMD
• Gladys Obaji

• Oral and Maxillofacial Surgery (Dentist) in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.