Sumter Oral & Maxillofacial Surgery PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

474 Issued in SC

Legal business name

SUMTER ORAL & MAXILLOFACIAL SURGERY PA

Doing business as

Dental Implant Center of Sumter

Practice address

1210 Wilson Hall Rd
Sumter, SC 29150-1889

Phone

(803) 905-4404

Fax

(803) 905-4406

NPI assigned

Apr 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael A McGinnis, DDSNPI 1780648576

Title

Owner

Phone

(803) 905-4404

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Dental Implant Center of Sumter Doing business as

Tax ID family

Sumter Oral Maxillofacial Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sumter Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Georgetown, SC
  • NPI 1437557121
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Sumter Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Georgetown, SC
  • NPI 1437557121
  NPPES parent name

Practitioners 1

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.

• Michael A McGinnis, DDS MS

  • Dentist
  • Sumter, SC
  • NPI 1780648576
  NPD (past) Authorized official

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294963200000",
    "number": "1083677884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 WILSON HALL RD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501889",
            "telephone_number": "803-905-4404",
            "fax_number": "803-905-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 WILSON HALL RD",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291501889",
            "telephone_number": "803-905-4404",
            "fax_number": "803-905-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMTER ORAL & MAXILLOFACIAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2011-01-14",
        "status": "A",
        "authorized_official_last_name": "MCGINNIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-905-4404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "3273",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9858",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "872701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "88003121",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "ZDK433",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Implant Center of Sumter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sumter Nephrology LLC
• Sumter OBGYN PA
• Sumter Opco, LLC (Covenant Place of Sumter)
• Sumter Operations LLC (Pinewood Nursing Care)
• Sumter Optical, LLC
• Sumter Orthopaedic Associates, LLC
• Sumter Pathology Associates
• Sumter Pediatrics, P.a.
• Sumter Pediatrics, P.a.
• Sumter Physical Therapy Clinic, LLC

• Oral and Maxillofacial Surgery (Dentist) in Sumter, SC
• Providers in Sumter, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.