Organization Active NPI

Profiles II Oral and Facial Surgery Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Palm Beach Gardens, FL
National Provider Identifier
1124355037
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN17793 Issued in FL
Legal business name
PROFILES II ORAL AND FACIAL SURGERY CENTER
Practice address
2560 Rca Blvd
Suite 102
Palm Beach Gardens, FL 33410-3338
Phone
(561) 622-9065
NPI assigned
Nov 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Authorized official

Name
Ms. Janice Scotland
Title
Office Manager
Phone
(561) 622-9065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DN17793 FL Primary

Addresses

Primary practice location

2560 Rca Blvd
Suite 102
Palm Beach Gardens, FL 33410-3338

Mailing address

2560 Rca Blvd
Suite 102
Palm Beach Gardens, FL 33410-3338
Phone (561) 622-9065

National Provider Directory

National Provider Directory

Locations

2051 45th St
Ste 205
West Palm Beach, FL 33407
Phone (561) 622-9065

Practitioners & affiliated clinicians

Practitioners 1

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": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310688000000",
    "number": "1124355037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 RCA BLVD",
            "address_2": "SUITE 102",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103338",
            "telephone_number": "561-622-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 RCA BLVD",
            "address_2": "SUITE 102",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103338",
            "telephone_number": "561-622-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFILES II ORAL AND FACIAL SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2011-07-15",
        "status": "A",
        "authorized_official_last_name": "SCOTLAND",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "561-622-9065",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN17793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.