Southwind Oral and Facial Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6423 Issued in KS

Legal business name

SOUTHWIND ORAL AND FACIAL SURGERY LLC

Practice address

2301 N. Waldron
Hutchinson, KS 67502-1133

Phone

(620) 663-1141

Fax

(620) 663-1373

NPI assigned

Sep 7, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jared DyeNPI 1710270590

Title

Owner

Phone

(620) 663-1141

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southwind Oral and Facial Surgery Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 2

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

• Jared Eric Dye, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hutchinson, KS
  • NPI 1710270590
  Medicare reassignment Care Compare group NPD Authorized official
• David Olatunji Omole, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Hutchinson, KS
  • NPI 1528622735
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1093818478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N. WALDRON",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021133",
            "telephone_number": "620-663-1141",
            "fax_number": "620-663-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N. WALDRON",
            "city": "HUTCHINSON",
            "state": "KS",
            "postal_code": "675021133",
            "telephone_number": "620-663-1141",
            "fax_number": "620-663-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWIND ORAL AND FACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A",
        "authorized_official_last_name": "DYE",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "620-663-1141",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KS",
            "license": "6423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "022955",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@southwindoms.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2301 N. Waldron",
            "city": "Hutchinson",
            "state": "KS",
            "country_code": "US",
            "postal_code": "675021133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southwind Oral and Facial Surgery",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Terry Michael Smith, CRNA
• Thomas W. Smith, MD
• Smiths Food & Drug Centers Inc
• Savannah Elise Snell, PA
• Robert Sourk, MD
• Audrey N Sperber, LMSW
• Kethlyn Ann Staab, LMFT
• Brenda M Staggs, PTA
• Robert Staggs, PA-C
• Jack Dean Stanfield Jr., D.C.

• Oral and Maxillofacial Surgery (Dentist) in Hutchinson, KS
• Providers in Hutchinson, KS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kansas

• 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.
• 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.