NPIMap

Organization Active NPI

Mid-Atlantic Center for Oral & Maxillofacial Surgery LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Seaford, DE
National Provider Identifier
1184166803
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
MID-ATLANTIC CENTER FOR ORAL & MAXILLOFACIAL SURGERY LLC
Practice address
8466 Herring Run Rd
Suite D
Seaford, DE 19973-5763
Phone
(302) 629-3588
Fax
(302) 629-0440
NPI assigned
Nov 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Authorized official

Name
Eric Spencer, DDS
Title
Owner
Phone
(302) 629-3588

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DE
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X DE Primary

Addresses

Primary practice location

8466 Herring Run Rd
Suite D
Seaford, DE 19973-5763

Mailing address

8466 Herring Run Rd
Suite D
Seaford, DE 19973-5763
Phone (302) 629-3588

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1184166803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8466 HERRING RUN RD",
            "address_2": "SUITE D",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199735763",
            "telephone_number": "302-629-3588",
            "fax_number": "302-629-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8466 HERRING RUN RD",
            "address_2": "SUITE D",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199735763",
            "telephone_number": "302-629-3588",
            "fax_number": "302-629-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC CENTER FOR ORAL & MAXILLOFACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-11",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-629-3588",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "DE",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.