Organization Active NPI

Edward a. Laga, Jr. D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Presque Isle, ME
National Provider Identifier
1568670685
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DEN4002 Issued in ME
Legal business name
EDWARD A. LAGA, JR. D.D.S.
Practice address
175 Academy St
Presque Isle, ME 04769-3103
Phone
(207) 764-3900
Fax
(207) 764-3788
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Authorized official

Name
Dr. Edward A. Laga Jr., D.D.S.
Title
Oral Surgeon
Phone
(207) 764-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X DEN4002 ME Primary

Addresses

Primary practice location

175 Academy St
Presque Isle, ME 04769-3103

Mailing address

175 Academy St
Presque Isle, ME 04769-3103
Phone (207) 764-3900

Other identifiers 1

IdentifierTypeStateIssuer
432544800MedicaidME

National Provider Directory

National Provider Directory

Locations

175 Academy St
Presque Isle, ME 04769
Phone (207) 764-3787

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": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1568670685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693103",
            "telephone_number": "207-764-3900",
            "fax_number": "207-764-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693103",
            "telephone_number": "207-764-3900",
            "fax_number": "207-764-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD A. LAGA, JR. D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "LAGA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "207-764-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ME",
            "license": "DEN4002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432544800",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.