NPIMap

Organization Active NPI

Northeast Oral & Maxillofacial

  • Oral and Maxillofacial Pathology Dentistry
  • Columbia, SC
National Provider Identifier
1407067473
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
Legal business name
NORTHEAST ORAL & MAXILLOFACIAL
Practice address
1118 Greenlawn Dr
Columbia, SC 29209-2606
Phone
(803) 695-1118
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Mrs. Tricia E. Lasseter
Title
Insurance Coordinator
Phone
(803) 699-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0106X Primary

Addresses

Primary practice location

1118 Greenlawn Dr
Columbia, SC 29209-2606

Mailing address

1118 Greenlawn Dr
Columbia, SC 29209-2606

Other names 1

  • GARNERS FERRY ORAL & MAXILLOFACIAL SURGERY CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
Northeast Oral Maxillo4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1407067473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 GREENLAWN DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292092606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 GREENLAWN DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292092606",
            "telephone_number": "803-695-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ORAL & MAXILLOFACIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "LASSETER",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "803-699-5900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GARNERS FERRY ORAL & MAXILLOFACIAL SURGERY CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.