NPIMap

Organization Active NPI

Suffolk Oral Surgery Associates LLP

  • Oral and Maxillofacial Surgery (Dentist)
  • Brentwood, NY
National Provider Identifier
1093753758
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
024719 Issued in NY
Legal business name
SUFFOLK ORAL SURGERY ASSOCIATES LLP
Practice address
601 Suffolk Ave
Suite 2
Brentwood, NY 11717-4309
Phone
(631) 273-4888
Fax
(631) 273-2398
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Authorized official

Name
Victoria Jonke
Title
Administrator
Phone
(631) 273-4888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 024719 NY Primary

Addresses

Primary practice location

601 Suffolk Ave
Suite 2
Brentwood, NY 11717-4309

Mailing address

601 Suffolk Ave
Suite 2
Brentwood, NY 11717-4309
Phone (631) 273-4888

National Provider Directory

National Provider Directory

Locations

601 Suffolk Ave
Ste 2
Brentwood, NY 11717
Phone (631) 273-4888

554 Larkfield Rd
Ste 108
East Northport, NY 11731
Phone (631) 368-9331

994 W Jericho Tpke
Ste 101
Smithtown, NY 11787
Phone (631) 543-0922

2500 Nesconset Hwy
Bldg 12D
Stony Brook, NY 11790
Phone (631) 689-7575

Practitioners & affiliated clinicians

Practitioners 6

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1093753758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SUFFOLK AVE",
            "address_2": "SUITE 2",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174309",
            "telephone_number": "631-273-4888",
            "fax_number": "631-273-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SUFFOLK AVE",
            "address_2": "SUITE 2",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174309",
            "telephone_number": "631-273-4888",
            "fax_number": "631-273-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK ORAL SURGERY ASSOCIATES LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "JONKE",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-273-4888"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "024719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.