Maxillofacial Surgical Arts

Primary specialty

SpecialistTaxonomy code 174400000X

License

034203 Issued in CA

Legal business name

MAXILLOFACIAL SURGICAL ARTS

Practice address

9066 Tampa Ave
Northridge, CA 91324-3523

Phone

(818) 993-5700

NPI assigned

Oct 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert Relle, D.D.S.

Title

Partner

Phone

(818) 993-5700

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1174702187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9066 TAMPA AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243523",
            "telephone_number": "818-993-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9066 TAMPA AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243523",
            "telephone_number": "818-993-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXILLOFACIAL SURGICAL ARTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "RELLE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "818-993-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "034203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Bral DO a Professional Medical Corporation
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• Christopher Mays-Rico

• Specialist in Northridge, CA
• Providers in Northridge, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.