Oral and Facial Surgery Center

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

Legal business name

ORAL AND FACIAL SURGERY CENTER

Practice address

811 S 28TH Ave
Hattiesburg, MS 39402-2602

Phone

(601) 261-2611

Fax

(601) 261-2711

NPI assigned

Dec 1, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Whitney A Powell

Title

Office Manager

Phone

(601) 261-2611

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Brian Jackson, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hattiesburg, MS
  • NPI 1841601556
  NPD
• John Boone Roberson Sr.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hattiesburg, MS
  • NPI 1871607812
  NPD (past)

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1043815855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022602",
            "telephone_number": "601-261-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022602",
            "telephone_number": "601-261-2611",
            "fax_number": "601-261-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND FACIAL SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-261-2611",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01951327",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03972317",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• One Community Development Center
• One Stop Healthcare Management LLC
• Kelechi Victor Onyekwere, DO
• Optometric Clinic, PA
• Oral & Maxillofacial Surgery Clinic of South Misssissippi, P.a. (Hattiesburg Oral Surgery)
• Orleans Park Rehabilitation Services, LLC
• Orthospine DME, LLC (OrthoSpine DME)
• Orthotic & Prosthetic Solutions LLC
• Amanda Louise Osborne, FNP
• Larry Lee Osenbaugh, RPH

• Oral and Maxillofacial Pathology Dentistry in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Oral and Maxillofacial Pathology Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.