Organization Active NPI

Rice Oral Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Glenshaw, PA
National Provider Identifier
1194349928
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
RICE ORAL MAXILLOFACIAL SURGERY PC
Practice address
1416 Mount Royal Blvd
Glenshaw, PA 15116-2206
Phone
(412) 779-0620
NPI assigned
Jun 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Dr. Jeremy Grant Rice, DO, DMDNPI 1750698387
Title
President
Phone
(412) 223-5880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1416 Mount Royal Blvd
Glenshaw, PA 15116-2206

Mailing address

1416 Mount Royal Blvd
Glenshaw, PA 15116-2206
Phone (412) 223-5880

Other practice location 1

35 S 2nd Ave
Clarion, PA 16214-1934
Phone (814) 226-8690

Other practice location 2

90 Beaver Dr
Du Bois, PA 15801-2440
Phone (814) 375-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210623000057 PA Part B Supplier - Clinic/Group Practice 4789085168 Receives reassigned benefits from 1 practitioner
Practice locations: Clarion, PA; Glenshaw, PA

National Provider Directory

National Provider Directory

Locations

1501 Mount Royal Blvd
Glenshaw, PA 15116
Phone (412) 486-3076

Practitioners & affiliated clinicians

Practitioners 2

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": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1194349928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 MOUNT ROYAL BLVD",
            "city": "GLENSHAW",
            "state": "PA",
            "postal_code": "151162206",
            "telephone_number": "412-223-5880",
            "fax_number": "214-223-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 MOUNT ROYAL BLVD",
            "city": "GLENSHAW",
            "state": "PA",
            "postal_code": "151162206",
            "telephone_number": "412-779-0620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 S 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Clarion",
            "state": "PA",
            "postal_code": "162141934",
            "country_code": "US",
            "telephone_number": "814-226-8690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Beaver Dr",
            "address_purpose": "LOCATION",
            "city": "Du Bois",
            "state": "PA",
            "postal_code": "158012440",
            "country_code": "US",
            "telephone_number": "814-375-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RICE ORAL MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-223-5880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO, DMD"
    },
    "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": []
}

Other providers in Glenshaw, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.