Thomas P Dougherty Oral Maxillofacial Surgery PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

THOMAS P DOUGHERTY ORAL MAXILLOFACIAL SURGERY PA

Practice address

5317 Limestone Rd
Wilmington, DE 19808-1252

Phone

(302) 239-2500

Fax

(302) 239-0552

NPI assigned

Apr 10, 2008

Organization subpart

No

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

Authorized official

Name

Thomas P DoughertyNPI 1043374515

Title

Oral Maxillofacial Surgeon

Phone

(302) 239-2500

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Practitioners 1

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

• Thomas Patrick Dougherty, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Wilmington, DE
  • NPI 1043374515
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1245403286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5317 LIMESTONE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081252",
            "telephone_number": "302-239-2500",
            "fax_number": "302-239-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5317 LIMESTONE RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081252",
            "telephone_number": "302-239-2500",
            "fax_number": "302-239-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS P DOUGHERTY ORAL MAXILLOFACIAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ORAL MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "302-239-2500"
    },
    "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": "0000912501",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "54490",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marguerite Thew, MD
• Maurice A Thew, MD
• Mary Beth Theyerl, MS CCC-SLP
• Thomas J. Maxwell, MD, LLC
• Febin Thomas Mathew, PT
• Nyhema Thomas Stokes
• Hope Diane Thomas-Glavin, DDS
• Amy Louise Thomas, ATC, CSCS
• Andrea O Thomas, LPN
• Bernadette Renee Thomas, DNP, APRN, FNP-C

• Oral and Maxillofacial Surgery (Dentist) in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Oral and Maxillofacial Surgery (Dentist) in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.