NPIMap

Organization Active NPI

Advanced Oral Surgery, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Council Bluffs, IA
National Provider Identifier
1154970655
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ADVANCED ORAL SURGERY, PLLC
Practice address
3265 S 24TH St
Council Bluffs, IA 51501-6901
Phone
(402) 934-8999
NPI assigned
Sep 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Authorized official

Name
Brittney Wiemer
Title
Practice Administrator
Phone
(402) 934-8999

Specialties & licenses 1

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

Addresses

Primary practice location

3265 S 24TH St
Council Bluffs, IA 51501-6901

Mailing address

5040 S 153Rd St
Omaha, NE 68137-5067
Phone (402) 934-8999

Other names 1

  • Council Bluffs Oral Surgery, PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Advanced Oral Surgery PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3265 S 24th St
Council Bluffs, IA 51501
Phone (402) 934-8999

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1154970655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 S 153RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681375067",
            "telephone_number": "402-934-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3265 S 24TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515016901",
            "telephone_number": "402-934-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ORAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A",
        "authorized_official_last_name": "WIEMER",
        "authorized_official_first_name": "BRITTNEY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "402-934-8999"
    },
    "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": [
        {
            "organization_name": "Council Bluffs Oral Surgery, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.