Miriam Caroline Omalley, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

027676L Issued in PA

Practice address

550 3Rd Ave
Ste 1
Kingston, PA 18704-5806

Phone

(570) 288-9070

Fax

(570) 288-4201

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Callahan and Bergey Associates P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Kingston, PA
  • NPI 1770557118
  Medicare reassignment NPD
• Wyoming Valley Oral Surgery PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Kingston, PA
  • NPI 1831962323
  Medicare reassignment NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1154419042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 3RD AVE",
            "address_2": "STE 1",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045806",
            "telephone_number": "570-288-9070",
            "fax_number": "570-288-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 3RD AVE",
            "address_2": "STE 1",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045806",
            "telephone_number": "570-288-9070",
            "fax_number": "570-288-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMALLEY",
        "first_name": "MIRIAM",
        "middle_name": "CAROLINE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "027676L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01696297",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neil Nowakowski, RP045445L
• Frank Obrien, MD
• Joseph Timothy Odriscoll
• Eva Ofcharsky
• Michael A Olenginski, D.O.
• Omni Health Services, Inc.
• Dan Opachko, PAC
• Timothy M Opiel, DMD
• Stephanie D Orfanella, MPT, CLT
• Alicia Orlowski, P.T.

• Oral and Maxillofacial Surgery (Dentist) in Kingston, PA
• Providers in Kingston, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.