Commonwealth Oral & Facial Surgery, PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0135583-3 Issued in VA

Legal business name

COMMONWEALTH ORAL & FACIAL SURGERY, PC

Practice address

8503 Patterson Ave
Suite B
Richmond, VA 23229-6442

Phone

(804) 354-1600

Fax

(804) 354-1607

NPI assigned

May 20, 2006

Last updated

Feb 20, 2019By 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

Gwen Eva Kennon

Title

Senior Billing Specialist

Phone

(804) 354-1602

Specialties & licenses 1

Addresses

Other names 1

• Nelson Miller Eschenroeder Zoghby Cyr Ferguson and Asso Former legal business name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 6

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.

• Thomas A Eschenroeder, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Midlothian, VA
  • NPI 1063462869
  Medicare reassignment NPD
• Peter J Broccoli

  • Oral and Maxillofacial Surgery (Dentist)
  • Midlothian, VA
  • NPI 1356921142
  NPD
• Vickas Agarwal, MD, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Richmond, VA
  • NPI 1164961454

  Oral and Maxillofacial Surgery

  NPD (past)
• Corey C. Burgoyne, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Fishersville, VA
  • NPI 1518174614
  NPD (past)
• Walter Keith Murphy, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mechanicsville, VA
  • NPI 1417951344
  NPD (past)
• Kimberly S. Swanson, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Richmond, VA
  • NPI 1497707772
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1144274382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71930",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232551930",
            "telephone_number": "804-354-1600",
            "fax_number": "804-354-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8503 PATTERSON AVE",
            "address_2": "SUITE B",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232296442",
            "telephone_number": "804-354-1600",
            "fax_number": "804-354-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH ORAL & FACIAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "KENNON",
        "authorized_official_first_name": "GWEN",
        "authorized_official_middle_name": "EVA",
        "authorized_official_title_or_position": "SENIOR BILLING SPECIALIST",
        "authorized_official_telephone_number": "804-354-1602"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0135583-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nelson Miller Eschenroeder Zoghby Cyr Ferguson and Asso",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Commonwealth Nursing Network
• Commonwealth of Virginia State Board of Health (Virginia Department of Health)
• Commonwealth of Virginia State Board of Health
• Commonwealth of Virginia State Board of Health (Virginia Department of Health Pharmacy Services)
• Commonwealth of Virginia State Board of Health (Richmond City Health District)
• Commonwealth Orthopedic Specialist
• Commonwealth Pain Management and Wellness, PLLC
• Commonwealth Pain Specialists, LLC (Commonwealth Pain Specialists)
• Commonwealth Pediatric Dentistry, PLLC
• Commonwealth Pediatrics

• Oral and Maxillofacial Surgery (Dentist) in Richmond, VA
• Providers in Richmond, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.