Organization Active NPI

Center for Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Evans, GA
National Provider Identifier
1538112016
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7520 Issued in GA
Legal business name
CENTER FOR ORAL & MAXILLOFACIAL SURGERY
Practice address
7011 Evans Town Center Blvd
Evans, GA 30809-4315
Phone
(706) 724-8735
Fax
(706) 722-7037
NPI assigned
May 18, 2006
Last updated
Jun 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Authorized official

Name
Leah Browne
Title
Billing Department
Phone
(706) 724-8735

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 7520 GA Primary

Addresses

Primary practice location

7011 Evans Town Center Blvd
Evans, GA 30809-4315

Mailing address

7011 Evans Town Center Blvd
Evans, GA 30809-4315
Phone (706) 724-8735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040507000298 GA Part B Supplier - Clinic/Group Practice 7618966573 Receives reassigned benefits from 6 practitioners
Practice locations: Evans, GA
O20170223002480 SC Part B Supplier - Clinic/Group Practice 7618966573 Receives reassigned benefits from 6 practitioners
Practice locations: North Augusta, SC

National Provider Directory

National Provider Directory

Locations

7011 Evans Town Center Blvd
Evans, GA 30809
Phone (706) 724-8735

7011 Evans Town Center Blvd
#3895
Evans, GA 30809

750 Gateway Center Blvd
Grovetown, GA 30813
Phone (762) 222-4180

1907 Pawnee St
Aiken, SC 29803
Phone (803) 649-3932

101 Nut Grove Dr
North Augusta, SC 29841
Phone (803) 278-2050

Practitioners & affiliated clinicians

Practitioners 8

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1538112016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 EVANS TOWN CENTER BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094315",
            "telephone_number": "706-724-8735",
            "fax_number": "706-722-7037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 EVANS TOWN CENTER BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094315",
            "telephone_number": "706-724-8735",
            "fax_number": "706-722-7037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "BROWNE",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "BILLING DEPARTMENT",
        "authorized_official_telephone_number": "706-724-8735"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "7520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.