Northwest Florida Oral and Maxillofacial Surgery, P.a.

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

DN18924 Issued in FL

Legal business name

NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY, P.A.

Practice address

4850 N 9TH Ave Ste 1
Pensacola, FL 32503-2407

Phone

(850) 478-7070

Fax

(850) 476-2513

NPI assigned

Jan 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Brett T. Laggan, D.D.S

Title

Oral & Maxillofacial Surgeon

Phone

(850) 478-7070

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Northwest Florida Oral and Maxillofacial Surgery PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northwest Florida Oral and Maxillofacial Surgery, PA

  • Oral and Maxillofacial Surgery Clinic/Center
  • Pensacola, FL
  • NPI 1699081919
  NPD tax ID

Locations

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1598069239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032407",
            "telephone_number": "850-478-7070",
            "fax_number": "850-476-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032407",
            "telephone_number": "850-478-7070",
            "fax_number": "850-476-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "LAGGAN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ORAL & MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "850-478-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18924",
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073210900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076708500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northpointe Retirement Community
• Rex L. Northup, MD
• Northwest Florida Anesthesia Consultants Inc
• Northwest Florida Comprehensive Services for Children, Inc.
• Northwest Florida Heart Group PA
• Northwest Florida Oral and Maxillofacial Surgery, PA
• Northwest Florida Pathology LLC
• Northwest Florida Physicians Group, LLC
• Northwest Florida Surgical Center, LLC
• Naomi Kirkland Norton, D.M.D.

• All providers in Pensacola, FL
• Oral and Maxillofacial Surgery Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.