NPIMap

Organization Active NPI

Alderdice Oral and Maxillofacial Surgeons

  • Oral and Maxillofacial Surgery (Dentist)
  • Somerset, KY
National Provider Identifier
1407298102
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ALDERDICE ORAL AND MAXILLOFACIAL SURGEONS
Practice address
100 Hardin LN
Ste B
Somerset, KY 42503-3812
Phone
(606) 679-8568
Fax
(606) 676-0868
NPI assigned
Jul 23, 2013
Last updated
Jul 23, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Authorized official

Name
Dr. Bennie Alderdice Sr., D.M.D.NPI 1518973478
Title
Owner
Phone
(606) 679-8568

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4939 KY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

100 Hardin LN
Ste B
Somerset, KY 42503-3812

Mailing address

100 Hardin LN
Ste B
Somerset, KY 42503-3812
Phone (606) 679-8568

National Provider Directory

National Provider Directory

Locations

100 Hardin Ln
Ste B
Somerset, KY 42503
Phone (606) 679-8568

Practitioners & affiliated clinicians

Practitioners 2

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": "1374537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1407298102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HARDIN LN",
            "address_2": "STE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033812",
            "telephone_number": "606-679-8568",
            "fax_number": "606-676-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HARDIN LN",
            "address_2": "STE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033812",
            "telephone_number": "606-679-8568",
            "fax_number": "606-676-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALDERDICE ORAL AND MAXILLOFACIAL SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "ALDERDICE",
        "authorized_official_first_name": "BENNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-679-8568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "4939",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; 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.