Summit Oral Surgery Center LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SUMMIT ORAL SURGERY CENTER LLC

Doing business as

Independence Surgery Center

Practice address

19921 E Jackson Dr
Independence, MO 64057-1596

Phone

(313) 600-2188

NPI assigned

Apr 4, 2026

Last updated

Aug 11, 2026By 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. Michael Lee, DDSNPI 1174902654

Title

Center Admin; Board of Managers

Phone

(816) 271-0110

Specialties & licenses 1

Addresses

Other names 1

• Independence Surgery Center Doing business as

Tax ID family

Summit Oral Surgery Center LLC2 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.

• Summit Oral Surgery Center LLC

  dba Independence Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Independence, MO
  • NPI 1437083615
  NPD tax ID

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 Lee, D.D.S.

  • Dentist
  • Independence, MO
  • NPI 1174902654
  NPD Authorized official

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

{
    "created_epoch": "1775260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1114868957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19921 E JACKSON DR",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571596",
            "telephone_number": "816-271-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19921 E JACKSON DR",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571596",
            "telephone_number": "313-600-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ORAL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-04",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CENTER ADMIN; BOARD OF MANAGERS",
        "authorized_official_telephone_number": "816-271-0110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Independence Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marie S. Styles
• Suchman and Darnall DDS, PC (Suchman and Darnall Family Dentistry)
• David Lawrence Suchman, D.D.S.
• Rodger Lawrence Suchman, DDS
• Timothy Paul Sullivan, D.C.
• Summit Oral Surgery Center LLC (Independence Surgery Center)
• Sena Marie Sumpter
• Sunshine Center Inc.
• Sunterra Independence Oc, LLC (Sunterra Springs Independence)
• Superior Radiology Consultants LLC

• Oral and Maxillofacial Surgery (Dentist) in Independence, MO
• Providers in Independence, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.