Organization Active NPI

Oral and Maxillofacial Surgery Innovations, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Harrisburg, PA
National Provider Identifier
1225126428
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ORAL AND MAXILLOFACIAL SURGERY INNOVATIONS, LLC
Practice address
4700 Union Deposit Rd
Suite 260
Harrisburg, PA 17111-3774
Phone
(717) 909-3239
Fax
(717) 909-3242
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Dr. Larry Pepper, DMDNPI 1770579310
Title
Owner
Phone
(717) 909-0530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4700 Union Deposit Rd
Suite 260
Harrisburg, PA 17111-3774

Mailing address

4700 Union Deposit Rd
Suite 260
Harrisburg, PA 17111-3774
Phone (717) 909-3239

National Provider Directory

National Provider Directory

Locations

4700 Union Deposit Rd
Ste 260
Harrisburg, PA 17111
Phone (717) 540-1777

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1225126428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD",
            "address_2": "SUITE 260",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-909-3239",
            "fax_number": "717-909-3242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 UNION DEPOSIT RD",
            "address_2": "SUITE 260",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113774",
            "telephone_number": "717-909-3239",
            "fax_number": "717-909-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFACIAL SURGERY INNOVATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "PEPPER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-909-0530",
        "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": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.