Mill Creek Oral & Maxillofacial Surgery Associates Inc

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

204E0000X Issued in OH

Legal business name

MILL CREEK ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC

Practice address

5437 Mahoning Ave Ste 12
Austintown, OH 44515-2421

Phone

(330) 792-2501

Fax

(330) 792-9249

NPI assigned

Feb 27, 2007

Last updated

Jan 23, 2012By 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

Dr. Mark L Billy, D.D.S.NPI 1538143508

Title

President

Phone

(330) 792-2501

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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.

• Mark L Billy, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Youngstown, OH
  • NPI 1538143508
  Medicare reassignment Care Compare group NPD Authorized official
• Craig A Wagley, DDS MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Austintown, OH
  • NPI 1235115833
  Medicare reassignment Care Compare group NPD
• Neilson Lane Wagley, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Austintown, OH
  • NPI 1427582964
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1063549236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5437 MAHONING AVE",
            "address_2": "SUITE 12",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152437",
            "telephone_number": "330-792-2501",
            "fax_number": "330-792-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5437 MAHONING AVE STE 12",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152421",
            "telephone_number": "330-792-2501",
            "fax_number": "330-792-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL CREEK ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "BILLY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-792-2501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "204E0000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2102638",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Merriman, PRS
• Holly S. Messina, CRNP
• Benjamin Meszar, CDCA
• Alonie Mikes
• Evan Thomas Mikulka, CDCA. 192321
• Alina N Mille, DPT
• Miller Psychiatric Services
• Allison M Miller, DPT
• Ann Marie Miller
• Brandon D Miller, PCC, LICDC

• Oral & Maxillofacial Surgery (D.M.D.) in Austintown, OH
• Providers in Austintown, OH by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.