NPIMap

Organization Active NPI

Prousi Oral & Facial Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Burlington Township, NJ
National Provider Identifier
1154860120
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
22DI02541600 Issued in NJ
Legal business name
PROUSI ORAL & FACIAL SURGERY, LLC
Practice address
1900 Mount Holly Rd
Building 500
Burlington Township, NJ 08016-4722
Phone
(609) 526-8650
Fax
(609) 526-8640
NPI assigned
Feb 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Authorized official

Name
Anthony Prousi, DDS, MDNPI 1992934830
Title
Owner / Surgeon
Phone
(609) 526-8650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 22DI02541600 NJ Primary

Addresses

Primary practice location

1900 Mount Holly Rd
Building 500
Burlington Township, NJ 08016-4722

Mailing address

1900 Mount Holly Rd
Building 500
Burlington Township, NJ 08016-4722
Phone (609) 526-8650

National Provider Directory

National Provider Directory

Locations

1900 Mount Holly Rd
Ste 500
Burlington Township, NJ 08016
Phone (609) 526-8650

Practitioners & affiliated clinicians

Practitioners 2

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": "1487808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1154860120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 MOUNT HOLLY RD",
            "address_2": "BUILDING 500",
            "city": "BURLINGTON TOWNSHIP",
            "state": "NJ",
            "postal_code": "080164722",
            "telephone_number": "609-526-8650",
            "fax_number": "609-526-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 MOUNT HOLLY RD",
            "address_2": "BUILDING 500",
            "city": "BURLINGTON TOWNSHIP",
            "state": "NJ",
            "postal_code": "080164722",
            "telephone_number": "609-526-8650",
            "fax_number": "609-526-8640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROUSI ORAL & FACIAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-23",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "PROUSI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER / SURGEON",
        "authorized_official_telephone_number": "609-526-8650",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02541600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.