NPIMap

Organization Active NPI

Maryland Oral Surgery Associates, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Annapolis, MD
National Provider Identifier
1265845739
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
MARYLAND ORAL SURGERY ASSOCIATES, LLC
Practice address
128 Lubrano Drive
Suite 300
Annapolis, MD 21401-7028
Phone
(410) 897-0111
Fax
(410) 897-0110
NPI assigned
Jun 3, 2014
Last updated
Aug 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Dr. Glenn A. Nathan, D.D.S
Title
President
Phone
(301) 340-6884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X MD Primary

Addresses

Primary practice location

128 Lubrano Drive
Suite 300
Annapolis, MD 21401-7028

Mailing address

14955 Shady Grove Road
Suite 350
Rockville, MD 20850-8700
Phone (301) 340-6884

National Provider Directory

National Provider Directory
Tax ID family
Maryland Oral Surgery Associates LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1265845739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14955 SHADY GROVE ROAD",
            "address_2": "SUITE 350",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208508700",
            "telephone_number": "301-340-6884",
            "fax_number": "301-340-3836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LUBRANO DRIVE",
            "address_2": "SUITE 300",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017028",
            "telephone_number": "410-897-0111",
            "fax_number": "410-897-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND ORAL SURGERY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "NATHAN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-340-6884",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.