Terre Haute Oral & Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12010748A Issued in IN

Legal business name

TERRE HAUTE ORAL & MAXILLOFACIAL SURGERY

Practice address

3630 S 4TH St
Terre Haute, IN 47802-5543

Phone

(317) 373-4164

NPI assigned

May 9, 2015

Last updated

May 9, 2015By 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

Mrs. Ruth Lee

Title

Office Manager

Phone

(317) 373-4164

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1431129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431129600000",
    "number": "1487032538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 S 4TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 S 4TH ST",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478025543",
            "telephone_number": "317-373-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRE HAUTE ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-09",
        "last_updated": "2015-05-09",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-373-4164",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12010748A",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12010652A",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12011416A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terre Haute Medical Corporation, PC
• Terre Haute Medical Laboratory, Inc (Medlab)
• Terre Haute Neurosurgical & Spine Clinic, LLC
• Terre Haute Neurosurgical and Spine Clinic, LLC
• Terre Haute Obstetrics & Gynecology, LLC
• Terre Haute Oral Surgery LLC (Terre Haute Oral & Maxillofacial Surgery)
• Terre Haute Pain Care PC
• Terre Haute Periodontics
• Terre Haute Physical Therapy PC
• Terre Haute Podiatry (Regional Foot and Ankle Center)

• Oral and Maxillofacial Surgery (Dentist) in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2015; 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.