NPIMap

Organization Active NPI

Facial and Oral Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Augusta, ME
National Provider Identifier
1407070006
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
3423 Issued in ME
Legal business name
FACIAL AND ORAL SURGERY ASSOCIATES
Practice address
5 Community Dr
Augusta, ME 04330-8087
Phone
(207) 622-5814
Fax
(207) 621-4360
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Authorized official

Name
Dr. R. Rubert BerubeNPI 1790715142
Title
Vice President / Secretary
Phone
(207) 622-5814

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 3423 ME Primary

Addresses

Primary practice location

5 Community Dr
Augusta, ME 04330-8087

Mailing address

5 Community Dr
Augusta, ME 04330-8087
Phone (207) 622-5814

Other identifiers 4

IdentifierTypeStateIssuer
M53500OtherMECIGNA HEALTHCARE
2091238OtherMEAETNA NUMBER
826700OtherMEUNITED CONCORDIA
K0832OtherMEANTHEM BLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1407070006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COMMUNITY DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308087",
            "telephone_number": "207-622-5814",
            "fax_number": "207-621-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COMMUNITY DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308087",
            "telephone_number": "207-622-5814",
            "fax_number": "207-621-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL AND ORAL SURGERY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "BERUBE",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "RUBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT / SECRETARY",
        "authorized_official_telephone_number": "207-622-5814",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "3423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "M53500",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NUMBER",
            "identifier": "2091238",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "826700",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "K0832",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.