NPIMap

Organization Active NPI

Georgia Dental Affiliates, LLC

Doing business as Coastal Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • St Simons Island, GA
National Provider Identifier
1285411694
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
GEORGIA DENTAL AFFILIATES, LLC
Doing business as
Coastal Oral Surgery Associates
Practice address
110 Office Park LN Ste 104
St Simons Island, GA 31522-6604
Phone
(912) 634-6600
NPI assigned
Sep 11, 2023
Last updated
Jan 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Authorized official

Name
Jeffrey Capes, DMDNPI 1336271543
Title
Managing Dentist
Phone
(912) 634-6600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

110 Office Park LN Ste 104
St Simons Island, GA 31522-6604

Mailing address

110 Office Park LN Ste 104
St Simons Island, GA 31522-6604
Phone (912) 634-6600

Other names 1

  • Coastal Oral Surgery Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coastal Oral Surgery Associates5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

110 Office Park Ln
Ste 104
St Simons Island, GA 31522
Phone (912) 634-6600

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1285411694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OFFICE PARK LN STE 104",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315226604",
            "telephone_number": "912-634-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OFFICE PARK LN STE 104",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315226604",
            "telephone_number": "912-634-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DENTAL AFFILIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "CAPES",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "MANAGING DENTIST",
        "authorized_official_telephone_number": "912-634-6600",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Oral Surgery Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Simons Island, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.