NPIMap

Organization Active NPI

Amp Oral and Maxillofacial Surgery, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Orlando, FL
National Provider Identifier
1144812348
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
AMP ORAL AND MAXILLOFACIAL SURGERY, PA
Practice address
3861 Avalon Park East Blvd
Orlando, FL 32828-4853
Phone
(407) 544-0139
NPI assigned
Feb 9, 2021
Last updated
Apr 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Authorized official

Name
Dr. Jonathan Clinton Elmore, DDSNPI 1598021016
Title
Owner/Authorized Official
Phone
(678) 480-9808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3861 Avalon Park East Blvd
Orlando, FL 32828-4853

Mailing address

10524 Moss Park Rd Ste 204-616
Orlando, FL 32832-5898
Phone (678) 480-9808

National Provider Directory

National Provider Directory

Locations

10524 Moss Park Rd
Ste 204616
Orlando, FL 32832

12711 Narcoossee Rd
Ste 100
Orlando, FL 32832
Phone (407) 627-1235

12711 Narcoossee Rd
Bldg B
Orlando, FL 32832
Phone (407) 627-1235

2907 17th St
Saint Cloud, FL 34769
Phone (407) 892-2135

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1144812348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10524 MOSS PARK RD STE 204-616",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328325898",
            "telephone_number": "678-480-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3861 AVALON PARK EAST BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284853",
            "telephone_number": "407-544-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMP ORAL AND MAXILLOFACIAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-09",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "ELMORE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "CLINTON",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "678-480-9808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.