NPIMap

Organization Active NPI

Maryland Oral Surgery Associates, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Rockville, MD
National Provider Identifier
1326159179
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
14955 Shady Grove Road
Suite 330
Rockville, MD 20850-8700
Phone
(301) 340-0101
Fax
(301) 340-1689
NPI assigned
Aug 31, 2006
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.NPI 1336220128
Title
President
Phone
(301) 340-6884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

14955 Shady Grove Road
Suite 330
Rockville, MD 20850-8700

Mailing address

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

Other names 1

  • Maryland Oral Surgery Associates, PA Former legal business name

National Provider Directory

National Provider Directory

Locations

6201 Greenbelt Rd
Ste M1
Berwyn Heights, MD 20740
Phone (301) 345-7007

9715 Medical Center Dr
Ste 533
Rockville, MD 20850
Phone (301) 340-0101

Practitioners & affiliated clinicians

Practitioners 7

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1326159179",
    "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": "14955 SHADY GROVE ROAD",
            "address_2": "SUITE 330",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208508700",
            "telephone_number": "301-340-0101",
            "fax_number": "301-340-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND ORAL SURGERY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryland Oral Surgery Associates, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rockville, 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.