Appomattox River Oral and Facial Surgery P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

APPOMATTOX RIVER ORAL AND FACIAL SURGERY P.C.

Practice address

595 Old Wagner Rd Ste a
Petersburg, VA 23805-9307

Phone

(804) 732-6532

Fax

(804) 861-8070

NPI assigned

Aug 19, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Robert John O'Neill, DDS MDNPI 1326203951

Title

President

Phone

(804) 732-6532

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Robert J O'Neill, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Petersburg, VA
  • NPI 1326203951
  NPD Authorized official

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1255007266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 OLD WAGNER RD STE A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059307",
            "telephone_number": "804-732-6532",
            "fax_number": "804-861-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 OLD WAGNER RD STE A",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059307",
            "telephone_number": "804-732-6532",
            "fax_number": "804-861-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPOMATTOX RIVER ORAL AND FACIAL SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-732-6532",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MD"
    },
    "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 Petersburg, VA
• Providers in Petersburg, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.