Wichita Oral Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

WICHITA ORAL SURGERY LLC

Practice address

12611 E 21St St N
Wichita, KS 67206-3594

Phone

(316) 742-1506

Fax

(316) 742-1507

NPI assigned

Jun 6, 2018

Last updated

Jun 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angelika Roe

Title

Credentialing

Phone

(888) 247-1869

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David J Gasper, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Fort Riley, KS
  • NPI 1740644178
  NPD (past)
• Matthew Eric Robertson, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Wichita, KS
  • NPI 1750343802
  NPD (past)

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1164914982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12611 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063594",
            "telephone_number": "316-742-1506",
            "fax_number": "316-742-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12611 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063594",
            "telephone_number": "316-742-1506",
            "fax_number": "316-742-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA ORAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "ROE",
        "authorized_official_first_name": "ANGELIKA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "888-247-1869"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wichita Ophthalmology,PA
• Wichita Optometry P.a.
• Wichita Optometry, P.a.
• Wichita Optometry, P.a.
• Wichita Optometry, P.a.
• Wichita Orthopaedic ASC LLC (Surgery Center of Kansas)
• Wichita Pain Associates PA (Wichita Pain Associates Cosmetic)
• Wichita Pain Center, LLC
• Wichita Pain Management LLC
• Wichita Parkinson's Center, LLC

• Oral and Maxillofacial Surgery Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.