Organization Active NPI

In Oral and Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Indianapolis, IN
National Provider Identifier
1265222103
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
IN ORAL AND FACIAL SURGERY
Practice address
1320 N Post Rd
Indianapolis, IN 46219-4210
Phone
(317) 898-2555
NPI assigned
May 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Authorized official

Name
Jackie Holloway
Title
Director of RCM
Phone
(854) 200-7970

Specialties & licenses 1

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

Addresses

Primary practice location

1320 N Post Rd
Indianapolis, IN 46219-4210

Mailing address

3700 Ingleside Blvd
Ladson, SC 29456-4141

Other names 1

  • Indianapolis Oral Surgery and Dental Implant Center Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1265222103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 INGLESIDE BLVD",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N POST RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194210",
            "telephone_number": "317-898-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN ORAL AND FACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "854-200-7970"
    },
    "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": [
        {
            "organization_name": "Indianapolis Oral Surgery and Dental Implant Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.