Organization Active NPI

Justin L Drab, DMD, PA

  • Oral and Maxillofacial Surgery Clinic/Center
  • Greensboro, NC
National Provider Identifier
1265617518
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
JUSTIN L DRAB, DMD, PA
Practice address
3824 N Elm St
Suite 209
Greensboro, NC 27455-2596
Phone
(336) 282-7475
Fax
(336) 282-7929
NPI assigned
Jan 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Dr. Justin L Drab, DMD
Title
Oral & Maxillofacial Surgeon
Phone
(336) 282-7475

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

3824 N Elm St
Suite 209
Greensboro, NC 27455-2596

Mailing address

3824 N Elm St
Suite 209
Greensboro, NC 27455-2596
Phone (336) 282-7475

Other names 1

  • The Oral Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081006000526 NC Part B Supplier - Clinic/Group Practice 7214986405 Receives reassigned benefits from 1 practitioner
Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory

Locations

3824 N Elm St
Ste 209
Greensboro, NC 27455
Phone (336) 282-7475

Practitioners & affiliated clinicians

Practitioners 2

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": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1265617518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 N ELM ST",
            "address_2": "SUITE 209",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552596",
            "telephone_number": "336-282-7475",
            "fax_number": "336-282-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 N ELM ST",
            "address_2": "SUITE 209",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552596",
            "telephone_number": "336-282-7475",
            "fax_number": "336-282-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN L DRAB, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "DRAB",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ORAL & MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "336-282-7475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Oral Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Oral Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.