NPIMap

Organization Active NPI

Oral and Maxillofacial Surgery Center of Lafayette

  • Oral and Maxillofacial Surgery (Dentist)
  • Lafayette, IN
National Provider Identifier
1154411163
Registry record updated Feb 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ORAL AND MAXILLOFACIAL SURGERY CENTER OF LAFAYETTE
Practice address
2020 Union Street
Suite 200
Lafayette, IN 47904
Phone
(765) 446-8808
Fax
(765) 446-9567
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2009

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

Authorized official

Name
Courtney A James
Title
Office Manager
Phone
(765) 446-8808

Specialties & licenses 1

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

Addresses

Primary practice location

2020 Union Street
Suite 200
Lafayette, IN 47904

Mailing address

2020 Union Street
Suite 200
Lafayette, IN 47904
Phone (765) 446-8808

National Provider Directory

National Provider Directory

Locations

2020 Union St
Ste 200
Lafayette, IN 47904
Phone (765) 446-8608

Practitioners & affiliated clinicians

Practitioners 4

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1154411163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 UNION STREET",
            "address_2": "SUITE 200",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47904",
            "telephone_number": "765-446-8808",
            "fax_number": "765-446-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 UNION STREET",
            "address_2": "SUITE 200",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47904",
            "telephone_number": "765-446-8808",
            "fax_number": "765-446-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFACIAL SURGERY CENTER OF LAFAYETTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "765-446-8808"
    },
    "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 Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; 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.