Greater Charlotte Oral & Facial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

GREATER CHARLOTTE ORAL & FACIAL SURGERY

Doing business as

Greater Charlotte Oral & Facial Surgery

Practice address

527 S New Hope Rd
Gastonia, NC 28054-4040

Phone

(704) 542-9600

Fax

(704) 215-6904

NPI assigned

Oct 25, 2018

Organization subpart

No

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

Authorized official

Name

Jennifer Hall

Title

Billing Supervisor

Phone

(704) 542-9600

Specialties & licenses 1

Addresses

Other names 1

• Greater Charlotte Oral & Facial Surgery Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Jesse Eric Ricciuti, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Monroe, NC
  • NPI 1003296831
  NPD (past)
• David Scott Coviak, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Warren, MI
  • NPI 1164829438
  NPD (past)

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1124595475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10042 PARK CEDAR DR STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108917",
            "telephone_number": "704-542-9600",
            "fax_number": "704-542-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 S NEW HOPE RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544040",
            "telephone_number": "704-542-9600",
            "fax_number": "704-215-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER CHARLOTTE ORAL & FACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "704-542-9600"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Charlotte Oral & Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Quetta Denise Gray
• Robert Elliott Gray
• Stephanie Lauren Gray, MD
• Dino A Graziano, M.D.
• Great Works Private Care LLC
• Greater Developmental Achievements
• Greater Harvest Homes LLC
• Greater Metrolina Mental Health Services
• Greater Metrolina Mental Health Services, Inc.
• James Greelish, MD

• Oral and Maxillofacial Surgery (Dentist) in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.