Atlantic Oral Surgery Center, PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

ATLANTIC ORAL SURGERY CENTER, PLLC

Practice address

229 Medical Park Rd Ste 300
Mooresville, NC 28117-8544

Phone

(704) 360-9995

Fax

(704) 360-2221

NPI assigned

Apr 5, 2022

Last updated

May 3, 2022By 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

Dr. Matthew Jeffrey Johnson Jr., MD, MPHNPI 1255710810

Title

Physician

Phone

(704) 360-9995

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, and the practitioner matching its NPPES authorized official.

• Matthew Jeffrey Johnson Jr., MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mooresville, NC
  • NPI 1255710810
  Authorized official Same address or phone

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1467193599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 TRADE CT STE F",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175546",
            "telephone_number": "704-360-9995",
            "fax_number": "704-360-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 MEDICAL PARK RD STE 300",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178544",
            "telephone_number": "704-360-9995",
            "fax_number": "704-360-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC ORAL SURGERY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "704-360-9995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christy Hurst Aul, PHARM. D

• Oral and Maxillofacial Surgery Clinic/Center in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Oral and Maxillofacial Surgery Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.