Advanced Oral and Facial Surgery of the Main Line, P.C.

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

DS023425L Issued in PA

Legal business name

ADVANCED ORAL AND FACIAL SURGERY OF THE MAIN LINE, P.C.

Practice address

223 Lancaster Avenue
Devon, PA 19333-1583

Phone

(610) 688-6683

Fax

(610) 971-0481

NPI assigned

Apr 27, 2007

Last updated

Aug 17, 2007By 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. Godfrey Joel Funari, DMDNPI 1720009863

Title

President

Phone

(610) 688-6683

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Godfrey Joel Funari, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Bryn Mawr, PA
  • NPI 1720009863
  NPD (past) Authorized official

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1306066683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 LANCASTER AVENUE",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331583",
            "telephone_number": "610-688-6683",
            "fax_number": "610-971-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 LANCASTER AVENUE",
            "city": "DEVON",
            "state": "PA",
            "postal_code": "193331583",
            "telephone_number": "610-688-6683",
            "fax_number": "610-971-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ORAL AND FACIAL SURGERY OF THE MAIN LINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "FUNARI",
        "authorized_official_first_name": "GODFREY",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-688-6683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS023425L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720009863",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 235 E Lancaster Avenue Opco, LLC (Recovery Center of America Outpatient at Malvern)
• Darian Abraham
• Sherin Sue Abraham, DO
• Jean Carlos Abreu Garcia
• Advanced Nursing Services, Inc
• Scott Eric Allen
• Paul Leroy Anderson Jr., DDS
• Anastasia Antoniadis, CCC/SLP
• Angela Appleton, RN
• At the Table Nutrition

• Oral and Maxillofacial Surgery Clinic/Center in Devon, PA
• Providers in Devon, PA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; 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.