Delaware Center for Oral Surgery and Dental Implants PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

C10005329 Issued in DE

Legal business name

DELAWARE CENTER FOR ORAL SURGERY AND DENTAL IMPLANTS PA

Practice address

131 E Chestnut Hill Rd
Newark, DE 19713-4043

Phone

(302) 369-1000

Fax

(302) 369-6016

NPI assigned

Jan 19, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David B Ettinger, MDNPI 1982625547

Title

Physician Oral Surgeon

Phone

(302) 369-1000

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David B. Ettinger, M.D. D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Newark, DE
  • NPI 1982625547
  Authorized official Same address or phone

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265585582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 INTERLACHEN CT",
            "city": "AVONDALE",
            "state": "PA",
            "postal_code": "193119747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 E CHESTNUT HILL RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134043",
            "telephone_number": "302-369-1000",
            "fax_number": "302-369-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE CENTER FOR ORAL SURGERY AND DENTAL IMPLANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETTINGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHYSICIAN ORAL SURGEON",
        "authorized_official_telephone_number": "302-369-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": "C10005329",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": "G10001099",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000932401",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Newark, DE
• Providers in Newark, 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 22, 2020; 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.