College Park Oral & Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

COLLEGE PARK ORAL & MAXILLOFACIAL SURGERY

Practice address

3677 W 86TH Street
Indianapolis, IN 46268-1902

Phone

(317) 872-7777

Fax

(317) 872-3174

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Dr. J Harold Smith II, DDS

Title

President

Phone

(317) 872-7777

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043309719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3677 W 86TH STREET",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "562681902",
            "telephone_number": "317-872-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3677 W 86TH STREET",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681902",
            "telephone_number": "317-872-7777",
            "fax_number": "317-872-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE PARK ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-872-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• 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.