Beachside Oral Surgery and Implants LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

18935 Issued in FL

Legal business name

BEACHSIDE ORAL SURGERY AND IMPLANTS LLC

Practice address

205 E Eau Gallie Blvd
257
Indian Harbour Beach, FL 32937-4873

Phone

(321) 473-8247

NPI assigned

May 27, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Jayanthi Chopra, DDS

Title

Employee

Phone

(321) 473-8247

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1164801825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E EAUGALLE BLVD",
            "address_2": "257",
            "city": "INDIAN HARBOURE BEACH",
            "state": "FL",
            "postal_code": "32937",
            "telephone_number": "321-473-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E EAU GALLIE BLVD",
            "address_2": "257",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374873",
            "telephone_number": "321-473-8247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHSIDE ORAL SURGERY AND IMPLANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-27",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "CHOPRA",
        "authorized_official_first_name": "JAYANTHI",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "321-473-8247",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "18935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Indian Harbour Beach, FL
• Providers in Indian Harbour Beach, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.