San Diego Center for Oral and Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SAN DIEGO CENTER FOR ORAL AND MAXILLOFACIAL SURGERY

Practice address

8008 Frost St
Suite 311
San Diego, CA 92123-4205

Phone

(858) 292-5175

Fax

(858) 292-9946

NPI assigned

May 24, 2012

Last updated

May 24, 2012By 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

Ms. Lynn Jane O'Keefe

Title

Administrator

Phone

(858) 292-5175

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1376803254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 FROST ST",
            "address_2": "SUITE 311",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234205",
            "telephone_number": "858-292-5175",
            "fax_number": "858-292-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 FROST ST",
            "address_2": "SUITE 311",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234205",
            "telephone_number": "858-292-5175",
            "fax_number": "858-292-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO CENTER FOR ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "O'KEEFE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "858-292-5175",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in San Diego, CA
• Providers in San Diego, 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 May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.