Wakarusa Oral Surgery, LC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6706 Issued in KS

Legal business name

WAKARUSA ORAL SURGERY, LC

Practice address

4901 Legends Dr
Lawrence, KS 66049-5800

Phone

(785) 856-6010

NPI assigned

Jul 17, 2009

Organization subpart

No

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

Authorized official

Name

Philip Charles Gaus Jr., DDS

Title

Manager/Member

Phone

(785) 856-6010

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247788800000",
    "number": "1306076971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 LEGENDS DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660495800",
            "telephone_number": "785-856-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 LEGENDS DR",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660495800",
            "telephone_number": "785-856-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKARUSA ORAL SURGERY, LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2009-07-17",
        "status": "A",
        "authorized_official_last_name": "GAUS",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "785-856-6010",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KS",
            "license": "6706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100224610B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Lawrence, KS
• Providers in Lawrence, KS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.