Elite Oral & Maxillofacial Surgery

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

22DI02332400 Issued in NJ

Legal business name

ELITE ORAL & MAXILLOFACIAL SURGERY

Practice address

246 Hamburg Tpke
Suite 304
Wayne, NJ 07470-2156

Phone

(973) 732-4555

Fax

(973) 732-4556

NPI assigned

Mar 27, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Shahin Ghobadi, D.M.D

Title

Owner/Oral Surgeon

Phone

(973) 732-4555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1578839262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE",
            "address_2": "SUITE 304",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702156",
            "telephone_number": "973-732-4555",
            "fax_number": "973-732-4556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE",
            "address_2": "SUITE 304",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702156",
            "telephone_number": "973-732-4555",
            "fax_number": "973-732-4556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "GHOBADI",
        "authorized_official_first_name": "SHAHIN",
        "authorized_official_title_or_position": "OWNER/ORAL SURGEON",
        "authorized_official_telephone_number": "973-732-4555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02332400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleos Family Services, LLC
• Sarah Margaret Elfallah, M.S CCC-SLP
• Sarah Elfanagely, MD
• Elite Home Rehab Services LLC
• Elite Neuro Diagnostic Services
• Elite Orthodontics
• Elite Orthopedics and Sports Medicine, P.a.
• Elite Pulmonary and Sleep Medicine PA
• Elite RX LLC
• Elite Surgical Center LLC

• Oral & Maxillofacial Surgery (D.M.D.) in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.