Cornerstone Oral and Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CORNERSTONE ORAL AND MAXILLOFACIAL SURGERY

Practice address

403 Cowart Ave
Valdosta, GA 31602-2635

Phone

(912) 408-7100

Fax

(912) 408-7101

NPI assigned

Oct 17, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Roger Myers, DMDNPI 1962518829

Title

Owner

Phone

(912) 432-0685

Specialties & licenses 2

Addresses

Other names 1

• Corenerstone Oral And Maxillofacial surgery Other name

Practitioners 1

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

• Roger Lee Myers, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • St Augustine, FL
  • NPI 1962518829

  Oral and Maxillofacial Surgery

  NPD Authorized official

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571270400000",
    "number": "1356983746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313220372",
            "telephone_number": "912-432-0685",
            "fax_number": "912-408-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 COWART AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022635",
            "telephone_number": "912-408-7100",
            "fax_number": "912-408-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-432-0685",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corenerstone Oral And Maxillofacial surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tracy Woske Corbett, LCSW
• Casey Bass Corbitt, RN
• Heather Renee Corbitt, M.ED, CCC-SLP
• Mark A Corbitt, MD
• Timothy Jason Corbitt Jr., CAA
• Patricia W. Cosey, LICENSED PROFESSIONA
• Christian Cosson
• Ryan Couillou, PHD
• Jackquelyn Countee
• Aaron Scott Courington, APRN

• All providers in Valdosta, GA
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.