Oral Reconstructive Jaw Surgery PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

440777 Issued in NY

Legal business name

ORAL RECONSTRUCTIVE JAW SURGERY PC

Practice address

563 Park Ave
New York, NY 10065-7379

Phone

(212) 838-0090

Fax

(212) 935-1296

NPI assigned

Mar 2, 2015

Last updated

Mar 2, 2015By 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. Gregory Charles Chotkowki, D.M.D

Title

Medical Director

Phone

(212) 838-0090

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1356733224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657379",
            "telephone_number": "212-838-0090",
            "fax_number": "212-935-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "563 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657379",
            "telephone_number": "212-838-0090",
            "fax_number": "212-935-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL RECONSTRUCTIVE JAW SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "CHOTKOWKI",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-838-0090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "440777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE JOINT COMMISSION",
            "identifier": "440777",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chimsom Orakwue, MD
• Oral and Implant Surgery of Manhattan, PLLC (Infinity Oral Surgery)
• Oral Dental PLLC
• Oral Facial Surgery on Park PC
• Oral Maxilofacial and Dental Pain Managment
• Oral Surgery Associates PC
• Oral Surgery, Mt. Sinai School of Medicine
• Nikki Krizia Oral, PT
• Elizabeth Oram
• Katherine Oram, PHD

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.