South Carolina Oral and Facial Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SOUTH CAROLINA ORAL AND FACIAL SURGERY LLC

Practice address

624 Front St
Georgetown, SC 29440-3624

Phone

(864) 706-3947

NPI assigned

Apr 26, 2022

Last updated

Apr 26, 2022By 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. Jason Wood, DMDNPI 1699185538

Title

Surgeon

Phone

(864) 706-3947

Specialties & licenses 1

Addresses

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.

• Jason Wood, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Georgetown, SC
  • NPI 1699185538
  NPD Authorized official

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1215671144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 FRONT ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 FRONT ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403624",
            "telephone_number": "864-706-3947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA ORAL AND FACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "864-706-3947",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "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": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.