Affiliates in Oral & Maxillofacial Surgery LTD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019021176 Issued in IL

Legal business name

AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD

Practice address

3112 Village Office PL
Champaign, IL 61822-7680

Phone

(217) 351-7111

Fax

(217) 351-7282

NPI assigned

Jun 5, 2008

Last updated

Jun 5, 2008By 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

Dr. Philip R. Banghart, DDSNPI 1982609087

Title

President/Oral Surgeon

Phone

(217) 351-7111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

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.

• Philip R Banghart, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Mattoon, IL
  • NPI 1982609087
  Medicare reassignment Care Compare group NPD Authorized official
• Theron Waisath, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Champaign, IL
  • NPI 1144423963
  Medicare reassignment Care Compare group NPD
• Richard J Claydon, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Bloomington, IL
  • NPI 1669533964
  NPD (past)
• Eugene Michael Ozment, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Champaign, IL
  • NPI 1518025394
  NPD (past)

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1215196290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3112 VILLAGE OFFICE PL",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618227680",
            "telephone_number": "217-351-7111",
            "fax_number": "217-351-7282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3112 VILLAGE OFFICE PL",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618227680",
            "telephone_number": "217-351-7111",
            "fax_number": "217-351-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "BANGHART",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT/ORAL SURGEON",
        "authorized_official_telephone_number": "217-351-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019021176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Adiputra
• Advanced Aesthetics Surgery & Laser Center, P.C.
• Advanced Chiropractic and Rehabilitation Center, P.C.
• Advanced Medical Transport East Inc. (AMT East)
• Audrey K Aeilts
• Affinity Dental Champaign LLC (Affinity Family Dental Champaign)
• Affordable Dentistry Today, PC (Affordable Dentistry Today - Champaign)
• Affordable Dentures & Implants - Champaign, P.C.
• Brandon Aguiar, LSW
• Alyssa M Aguirre

• Oral and Maxillofacial Surgery (Dentist) in Champaign, IL
• Providers in Champaign, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.