Integrative Oral & Facial Surgery, P.a.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

13271 Issued in MD

Legal business name

INTEGRATIVE ORAL & FACIAL SURGERY, P.A.

Practice address

1 Bank St
Suite 240
Gaithersburg, MD 20878-1504

Phone

(301) 926-4800

Fax

(301) 926-4899

NPI assigned

Mar 24, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jay S Nokkeo, D.M.D.

Title

President

Phone

(301) 926-4800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristopher D Paik, D.M.D. M.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Gaithersburg, MD
  • NPI 1083030225
  NPD

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1205150935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BANK ST",
            "address_2": "SUITE 240",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781504",
            "telephone_number": "301-926-4800",
            "fax_number": "301-926-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BANK ST",
            "address_2": "SUITE 240",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781504",
            "telephone_number": "301-926-4800",
            "fax_number": "301-926-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE ORAL & FACIAL SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-24",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "NOKKEO",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-926-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "13271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.