Mt Oms Specialty Dental Services, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MT OMS SPECIALTY DENTAL SERVICES, PLLC

Doing business as

Billings Oral Surgery & Dental Implant Center
Summit Oral Surgery & Implant Center

Practice address

152 S 32ND St W Ste B
Billings, MT 59102-6875

Phone

(406) 245-4414

NPI assigned

Aug 17, 2021

Organization subpart

No

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

Authorized official

Name

Charlotte Dasch

Title

Director of Provider Relations

Phone

(504) 638-0303

Specialties & licenses 1

Addresses

Other names 2

• Billings Oral Surgery & Dental Implant Center Doing business as
• Summit Oral Surgery & Implant Center Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MT, WY2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mt Oms Specialty Dental Services, PLLC

  dba Billings Oral Surgery & Dental Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1578329603

  O20220308000682

  Same enrollment
• Mt Oms Specialty Dental Services, PLLC

  dba Summit Oral Surgery & Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1780378174

  O20220308000682

  Same enrollment

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Mt Oms Specialty Dental Services, PLLC

  dba Billings Oral Surgery & Dental Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1578329603
  NPPES parent name
• Mt Oms Specialty Dental Services, PLLC

  dba Summit Oral Surgery & Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1780378174
  NPPES parent name

Practitioners 2

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

• Andrew George Boyce, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1336282458

  WY

  Medicare reassignment Care Compare group NPD
• Kyle Dale Tracy, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1225357734

  WY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1255007589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091401",
            "telephone_number": "504-638-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 S 32ND ST W STE B",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591026875",
            "telephone_number": "406-245-4414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Henry Chapple St",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591061839",
            "country_code": "US",
            "telephone_number": "406-259-7438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MT OMS SPECIALTY DENTAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER RELATIONS",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office",
            "affiliation": "N",
            "address_1": "152 S 32nd St W",
            "city": "Billings",
            "state": "MT",
            "country_code": "US",
            "postal_code": "591026875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "office",
            "affiliation": "N",
            "address_1": "625 Henry Chapple St",
            "city": "Billings",
            "state": "MT",
            "country_code": "US",
            "postal_code": "591061839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Billings Oral Surgery & Dental Implant Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Summit Oral Surgery & Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Billings, MT
• Providers in Billings, MT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.