NPIMap

Organization Active NPI

Oral and Facial Surgeons of Ohio

  • Oral and Maxillofacial Surgery (Dentist)
  • Dublin, OH
National Provider Identifier
1043427883
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
30016487 Issued in OH
Legal business name
ORAL AND FACIAL SURGEONS OF OHIO
Practice address
5155 Bradenton Ave
Suite 100
Dublin, OH 43017-7558
Phone
(614) 764-9455
Fax
(614) 526-3745
NPI assigned
May 17, 2007
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. James P. Ellis, DDS, MSNPI 1699828533
Title
Vice President
Phone
(614) 764-9455

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 30016487 OH Primary

Addresses

Primary practice location

5155 Bradenton Ave
Suite 100
Dublin, OH 43017-7558

Mailing address

5155 Bradenton Ave
Suite 100
Dublin, OH 43017-7558
Phone (614) 764-9455

National Provider Directory

National Provider Directory

Locations

5155 Bradenton Ave
Ste 100
Dublin, OH 43017
Phone (614) 764-9455

Practitioners & affiliated clinicians

Practitioners 6

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": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043427883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5155 BRADENTON AVE",
            "address_2": "SUITE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177558",
            "telephone_number": "614-764-9455",
            "fax_number": "614-526-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5155 BRADENTON AVE",
            "address_2": "SUITE 100",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177558",
            "telephone_number": "614-764-9455",
            "fax_number": "614-526-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND FACIAL SURGEONS OF OHIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "614-764-9455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30016487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

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.