Organization Active NPI

Billy B. Laun II, DDS, PC

Doing business as Oral & Maxillofacial Surgery of Carbondale, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Carbondale, IL
National Provider Identifier
1194381640
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
BILLY B. LAUN II, DDS, PC
Doing business as
Oral & Maxillofacial Surgery of Carbondale, Inc
Practice address
1111 E Walnut St Ste B
Carbondale, IL 62901-5000
Phone
(618) 529-2571
Fax
(618) 529-2572
NPI assigned
May 9, 2019
Last updated
Sep 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Authorized official

Name
Billy B Laun II, DDSNPI 1780982587
Title
Owner/Provider
Phone
(618) 529-2571

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1111 E Walnut St Ste B
Carbondale, IL 62901-5000

Mailing address

1111 E Walnut St Ste B
Carbondale, IL 62901-5000

Other names 1

  • Oral & Maxillofacial Surgery of Carbondale, Inc Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2171607Oral & Maxillofacial Surgery of Carbondale1111 E Walnut St - Ste B, Carbondale, IL 62901Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory

Locations

1111 E Walnut St
Ste B
Carbondale, IL 62901
Phone (618) 529-2571

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1194381640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E WALNUT ST STE B",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E WALNUT ST STE B",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629015000",
            "telephone_number": "618-529-2571",
            "fax_number": "618-529-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILLY B. LAUN II, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "LAUN",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "618-529-2571",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "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": [
        {
            "organization_name": "Oral & Maxillofacial Surgery of Carbondale, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.