Oral Surgery Center, S.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL SURGERY CENTER, S.C.

Practice address

1203 8TH St
Baraboo, WI 53913-1805

Phone

(608) 356-2112

Fax

(608) 356-0919

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Erich Herbst, DDS

Title

President

Phone

(608) 356-2112

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

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

• Steven K. Anderson, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Baraboo, WI
  • NPI 1265587497
  Medicare reassignment NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245374362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 8TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131805",
            "telephone_number": "608-356-2112",
            "fax_number": "608-356-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 8TH ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131805",
            "telephone_number": "608-356-2112",
            "fax_number": "608-356-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERBST",
        "authorized_official_first_name": "ERICH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-356-2112",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38382200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEANCARE PROVIDER #",
            "identifier": "518579",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Barbara Ostrowski, RN
• Samuel Overlien, LCSW
• Kelly Ann Palmer, MSW, LCSW
• Tom R Pankratz, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Baraboo, WI
• Providers in Baraboo, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.