North Coast Oral & Maxillofacial Surgery, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

NORTH COAST ORAL & MAXILLOFACIAL SURGERY, INC.

Practice address

2500 W. Strub Rd.
Noms Professional BLDG. #1
Sandusky, OH 44870

Phone

(419) 627-8131

Fax

(419) 621-1773

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Terence Patrick Kelly, D.D.S.

Title

President

Phone

(419) 627-8131

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marianne L. Coburn, D.D.S., Terence P. Kelly, D.D.S., & John Helmkamp, Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marianne Lucille Coburn, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Sandusky, OH
  • NPI 1568502516
  NPD (past)
• Adarsh M Mehta, DMD, MD

  • Dentist
  • Sandusky, OH
  • NPI 1477075489
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1609916667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W. STRUB RD.",
            "address_2": "NOMS PROFESSIONAL BLDG. #1",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "44870",
            "telephone_number": "419-627-8131",
            "fax_number": "419-621-1773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W. STRUB RD.",
            "address_2": "NOMS PROFESSIONAL BLDG. #1",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "44870",
            "telephone_number": "419-627-8131",
            "fax_number": "419-621-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST ORAL & MAXILLOFACIAL SURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "TERENCE",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-627-8131",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2089789",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marianne L. Coburn, D.D.S., Terence P. Kelly, D.D.S., & John Helmkamp,",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Linda Wanjiku Njoroge, M.D.
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• North Coast Cancer Care, Inc
• North Coast Clinical Laboratory, Inc.
• North Coast Professional Company, LLC
• North Coast Professional Company, LLC
• North Coast Professional Company, LLC
• North Coast Surgical Associates, Inc.
• North Coast Transitional Care, Inc.

• Oral and Maxillofacial Surgery (Dentist) in Sandusky, OH
• Providers in Sandusky, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.