NPIMap

Organization Active NPI

Implantis Oral & Facial Surgery, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Sarasota, FL
National Provider Identifier
1114291002
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN18583 Issued in FL
Legal business name
IMPLANTIS ORAL & FACIAL SURGERY, PA
Practice address
3940 Swift Rd
Sarasota, FL 34231-6541
Phone
(941) 923-0033
Fax
(941) 922-4621
NPI assigned
Feb 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

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

Authorized official

Name
Gary Raska, DMDNPI 1013920669
Title
President
Phone
(941) 923-0033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DN18583 FL Primary

Addresses

Primary practice location

3940 Swift Rd
Sarasota, FL 34231-6541

Mailing address

3940 Swift Rd
Sarasota, FL 34231-6541
Phone (941) 923-0033

Other identifiers 1

IdentifierTypeStateIssuer
1013920669OtherFLINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

3940 Swift Rd
Sarasota, FL 34231
Phone (941) 923-0033

Practitioners & affiliated clinicians

Practitioners 3

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": "1330041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1114291002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 SWIFT RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342316541",
            "telephone_number": "941-923-0033",
            "fax_number": "941-922-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 SWIFT RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342316541",
            "telephone_number": "941-923-0033",
            "fax_number": "941-922-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPLANTIS ORAL & FACIAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "RASKA",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-923-0033",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1013920669",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.