NPIMap

Organization Active NPI

Hanover Oral Surgery PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Lebanon, NH
National Provider Identifier
1043636616
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
2601 Issued in NH
Legal business name
HANOVER ORAL SURGERY PLLC
Practice address
367 Route 120
Unit E-1
Lebanon, NH 03766-1430
Phone
(603) 643-1700
Fax
(603) 643-1702
NPI assigned
Mar 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Authorized official

Name
Dr. Terry W Bradigan, DDSNPI 1538234380
Title
Owner
Phone
(603) 643-1700

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 Clinic/Center 261QS0112X 2601 NH Primary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 03746 NH

Addresses

Primary practice location

367 Route 120
Unit E-1
Lebanon, NH 03766-1430

Mailing address

367 Route 120
Unit E-1
Lebanon, NH 03766-1430
Phone (603) 643-1700

National Provider Directory

National Provider Directory

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": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1043636616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 ROUTE 120",
            "address_2": "UNIT E-1",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661430",
            "telephone_number": "603-643-1700",
            "fax_number": "603-643-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 ROUTE 120",
            "address_2": "UNIT E-1",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661430",
            "telephone_number": "603-643-1700",
            "fax_number": "603-643-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANOVER ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "BRADIGAN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-643-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NH",
            "license": "2601",
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NH",
            "license": "03746",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.