South Sound Oral Surgery PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SOUTH SOUND ORAL SURGERY PLLC

Practice address

1220 W 1St St
Ste a
Centralia, WA 98531-3018

Phone

(360) 736-0715

Fax

(360) 330-5091

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Laura Jean Caswell

Title

Office Manager

Phone

(360) 736-0715

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Christopher Eric Crecelius, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Olympia, WA
  • NPI 1447486170
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1396830238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 W 1ST W",
            "address_2": "STE A",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-736-0715",
            "fax_number": "360-330-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 W 1ST ST",
            "address_2": "STE A",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985313018",
            "telephone_number": "360-736-0715",
            "fax_number": "360-330-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SOUND ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "CASWELL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-736-0715",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Soteros, AAC, CPC
• Levi Robert Soteros
• South Creek SNF Healthcare LLC
• South Puget Sound ABA LLC
• South Sound Inpatient Physicians PLLC
• South Sound Radiology - Lewis County
• Jordan Southern
• Southwest Washington Anesthesia PS
• Southwest Washington Diagnostics LP
• Michael Spain

• Oral and Maxillofacial Surgery (Dentist) in Centralia, WA
• Providers in Centralia, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

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