NPIMap

Organization Active NPI

Maryland Oral Surgery Associates PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Crofton, MD
National Provider Identifier
1346415882
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12859 Issued in MD
Legal business name
MARYLAND ORAL SURGERY ASSOCIATES PA
Practice address
1667 Crofton Ctr
Suite 7a
Crofton, MD 21114-1303
Phone
(410) 721-0700
Fax
(410) 721-5459
NPI assigned
Apr 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Maureen Petersen
Title
Operations Manager
Phone
(301) 340-6884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 12859 MD Primary

Addresses

Primary practice location

1667 Crofton Ctr
Suite 7a
Crofton, MD 21114-1303

Mailing address

14955 Shady Grove Rd
Suite 330
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.

Locations

1667 Crofton Ctr
Ste 7A
Crofton, MD 21114
Phone (301) 261-6333

NPI Registry JSON

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1346415882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14955 SHADY GROVE RD",
            "address_2": "SUITE 330",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208508700",
            "telephone_number": "301-340-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 CROFTON CTR",
            "address_2": "SUITE 7A",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141303",
            "telephone_number": "410-721-0700",
            "fax_number": "410-721-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND ORAL SURGERY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "301-340-6884"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "12859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.