Thomas R. Michaelis, D.D.S., M.D., Inc, Ryan M. Kriwanek, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

38855 Issued in CA

Legal business name

THOMAS R. MICHAELIS, D.D.S., M.D., INC, RYAN M. KRIWANEK, D.D.S., M.D.

Doing business as

Newport Oral Surgery

Practice address

1401 Avocado Ave. Suite 506
Newport Beach, CA 92660

Phone

(949) 760-1661

Fax

(949) 760-8016

NPI assigned

Oct 21, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Raymond Michaelis, DDS, MDNPI 1518029115

Title

Partner

Phone

(949) 760-1661

Specialties & licenses 5

Addresses

Other names 1

• Newport Oral Surgery Doing business as

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas R Michaelis, DDS MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Costa Mesa, CA
  • NPI 1518029115
  NPD (past) Authorized official
• David Bell, M.D. D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Orange, CA
  • NPI 1346430279

  Oral and Maxillofacial Surgery

  NPD (past)
• Vivian Jui, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Irvine, CA
  • NPI 1295800209
  NPD (past)
• Ryan Kriwanek, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
  • NPI 1316268253
  NPD (past)
• Gary L Wyatt, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Costa Mesa, CA
  • NPI 1003978602
  NPD (past)

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1356892657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE. SUITE 506",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-760-1661",
            "fax_number": "949-760-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 AVOCADO AVE. SUITE 506",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92660",
            "telephone_number": "949-760-1661",
            "fax_number": "949-760-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS R. MICHAELIS, D.D.S., M.D., INC, RYAN M. KRIWANEK, D.D.S., M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "MICHAELIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "949-760-1661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "22313",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "38855",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "42745",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "58948",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Newport Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; 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.