NPIMap

Organization Active NPI

Raritan Bay Oral & Maxillofacial Surgery PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Perth Amboy, NJ
National Provider Identifier
1467739714
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12795 Issued in NJ
Legal business name
RARITAN BAY ORAL & MAXILLOFACIAL SURGERY PA
Practice address
276 High St
Perth Amboy, NJ 08861-4406
Phone
(732) 442-1860
Fax
(732) 442-8896
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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

Authorized official

Name
Dr. George W Flugrad, DMDNPI 1598745531
Title
Owner
Phone
(732) 442-1860

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 12795 NJ Primary

Addresses

Primary practice location

276 High St
Perth Amboy, NJ 08861-4406

Mailing address

276 High St
Perth Amboy, NJ 08861-4406
Phone (732) 442-1860

Other identifiers 1

IdentifierTypeStateIssuer
1873407MedicaidNJ

National Provider Directory

National Provider Directory

Locations

276 High St
Perth Amboy, NJ 08861
Phone (732) 442-1860

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1467739714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 HIGH ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614406",
            "telephone_number": "732-442-1860",
            "fax_number": "732-442-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 HIGH ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088614406",
            "telephone_number": "732-442-1860",
            "fax_number": "732-442-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RARITAN BAY ORAL & MAXILLOFACIAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "FLUGRAD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-442-1860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "12795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1873407",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.