Golden Isles Oral Surgery, L.L.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN011864 Issued in GA

Legal business name

GOLDEN ISLES ORAL SURGERY, L.L.C.

Practice address

17 Professional Drive
Suite 100
Brunswick, GA 31520-3794

Phone

(912) 264-6420

Fax

(912) 264-6242

NPI assigned

Sep 11, 2012

Last updated

Oct 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer E. Hall, D.M.D.NPI 1972643476

Title

Owner

Phone

(912) 264-6420

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Jennifer E Hall, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Savannah, GA
  • NPI 1972643476
  NPD (past) Authorized official

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1205186863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 PROFESSIONAL DRIVE",
            "address_2": "SUITE 100",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203794",
            "telephone_number": "912-264-6420",
            "fax_number": "912-264-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 PROFESSIONAL DRIVE",
            "address_2": "SUITE 100",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203794",
            "telephone_number": "912-264-6420",
            "fax_number": "912-264-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN ISLES ORAL SURGERY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-264-6420",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN011864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "667957245C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Golden Isles Dental Associates, LLC
• Golden Isles Dentistry
• Golden Isles Family Healthcare, LLC
• Golden Isles Foot Surgery Center
• Golden Isles Neurology, PC
• Golden Isles Pain-MD, LLC (Pain - MD)
• Golden Isles Palliative Care, Inc.
• Golden Isles Pediatrics Inc
• Golden Isles Prosthetics & Avery Watson Strickland Sole MBR
• Golden Isles Psychiatric Associates, P.C.

• Oral and Maxillofacial Surgery (Dentist) in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.