Statesboro Oral and Maxillofacial Surgery, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

STATESBORO ORAL AND MAXILLOFACIAL SURGERY, INC.

Practice address

4463 Country Club Rd
Statesboro, GA 30458-9188

Phone

(912) 764-4495

Fax

(912) 764-3650

NPI assigned

Mar 27, 2019

Organization subpart

No

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

Authorized official

Name

Troy M Lawhorn, DMDNPI 1285750166

Title

President

Phone

(912) 764-4495

Specialties & licenses 2

Addresses

Practitioners 1

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

• Troy Michael Lawhorn, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Statesboro, GA
  • NPI 1285750166
  NPD (past) Authorized official

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1497216980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4463 COUNTRY CLUB RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589188",
            "telephone_number": "912-764-4495",
            "fax_number": "912-764-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4463 COUNTRY CLUB RD",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589188",
            "telephone_number": "912-764-4495",
            "fax_number": "912-764-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESBORO ORAL AND MAXILLOFACIAL SURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "LAWHORN",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-764-4495",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Statesboro Medical Group, LLC
• Statesboro Neurosurgery, LLC
• Statesboro OB-GYN Specialists, PC
• Statesboro Oncology Assoc.
• Statesboro Opco LLC
• Statesboro Pathology Associates
• Statesboro Pediatric Dentistry, LLC
• Statesboro Physical Therapy Services Inc
• Statesboro Plastic Surgery
• Statesboro Psychiatric Associates

• Oral and Maxillofacial Surgery (Dentist) in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.