Lake Geneva Oral and Maxillofacial Surgery, LTD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

LAKE GENEVA ORAL AND MAXILLOFACIAL SURGERY, LTD

Practice address

312 Center St
Lake Geneva, WI 53147-1904

Phone

(262) 248-8766

Fax

(262) 248-6790

NPI assigned

Aug 3, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adam Ozment, D.D.S.

Title

President

Phone

(262) 248-8766

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Joseph Heinz, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Geneva, WI
  • NPI 1972129427
  NPD
• Ernst A. Cornielsen, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Geneva, WI
  • NPI 1447268651
  NPD (past)
• Ted Albert Hughes, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • East Meadow, NY
  • NPI 1104082494
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1063420206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 CENTER ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471904",
            "telephone_number": "262-248-8766",
            "fax_number": "262-248-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 CENTER ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471904",
            "telephone_number": "262-248-8766",
            "fax_number": "262-248-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE GENEVA ORAL AND MAXILLOFACIAL SURGERY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "OZMENT",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-248-8766",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Kutis, LAT
• Ladd F. Koresch O.D., S.C.
• Duanne Lafrenz, MSW, LCSW
• Lake Geneva Chiropractic Partners
• Lake Geneva Dental Care LLC
• Lake Geneva Wellness Clinic LLC
• Lake Geneva-Genoa City Union High School District
• Lakes Area Counseling Clinic
• Lakes Area Physical Therapy, LLC
• Lakes Counseling Center, LLC

• Oral and Maxillofacial Surgery (Dentist) in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.