Battle Creek Oral and Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11052 Issued in MI

Legal business name

BATTLE CREEK ORAL AND MAXILLOFACIAL SURGERY

Practice address

3610 Capital Avenue SW
Battle Creek, MI 49015

Phone

(269) 965-1339

Fax

(269) 965-2281

NPI assigned

Dec 17, 2007

Last updated

Dec 17, 2007By 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. Wendy H Lewis

Title

Office

Phone

(269) 965-1339

Specialties & licenses 2

Addresses

Other identifiers 4

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.

• Jonathan Bonnet, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Battle Creek, MI
  • NPI 1447679444

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1197849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197849600000",
    "number": "1548443294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 CAPITAL AVENUE SW",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49015",
            "telephone_number": "269-965-1339",
            "fax_number": "269-965-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 CAPITAL AVENUE SW",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49015",
            "telephone_number": "269-965-1339",
            "fax_number": "269-965-2281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATTLE CREEK ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-17",
        "last_updated": "2007-12-17",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OFFICE",
        "authorized_official_telephone_number": "269-965-1339",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "11052",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "14976",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020698",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2582361",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3020670",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4061917",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Battle Creek SNF Opco LLC
• Battle Creek SNF Operations LLC
• Battle Creek Sports Medicine and Orthopedic Center, PC (Great Lakes Bone and Joint Center, PC)
• Battle Creek Surgical, PC
• Battle Creek Urgent Care Walk in Clinic PC

• Oral and Maxillofacial Surgery (Dentist) in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; 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.