Greenville Oral Maxillofacial Surgery, P.a., a South Carolina Professi

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

GREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI

Doing business as

Greenville Oral Surgery Partners

Practice address

3929 S Highway 14
Greenville, SC 29615-6138

Phone

(864) 281-9119

Fax

(864) 281-9776

NPI assigned

Mar 9, 2007

Last updated

Dec 3, 2024By 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

Dr. James C Wilson, DMDNPI 1912003468

Title

President

Phone

(864) 281-9119

Specialties & licenses 1

Addresses

Other names 1

• Greenville Oral Surgery Partners Doing business as

Tax ID family

River Falls Oral Surgery3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Greenville Oral Maxillofacial Surgery, P.a., a South Carolina Professi

  dba Summerville Oral Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Summerville, SC
  • NPI 1184506693
  NPD tax ID
• River Falls Oral Surgery

  • Oral and Maxillofacial Pathology Dentistry
  • Duncan, SC
  • NPI 1174656540
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Greenville Oral Maxillofacial Surgery, P.a., a South Carolina Professi

  dba Summerville Oral Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Summerville, SC
  • NPI 1184506693
  NPPES parent name

Practitioners 3

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.

• James C Wilson, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenville, SC
  • NPI 1912003468
  NPD (past) Authorized official
• Jill Emily Gibson, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenville, SC
  • NPI 1437648045
  NPD (past)
• James Lee Moore, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenville, SC
  • NPI 1457457913
  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1619008547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 S HIGHWAY 14",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156138",
            "telephone_number": "864-281-9119",
            "fax_number": "864-281-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 S HIGHWAY 14",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156138",
            "telephone_number": "864-281-9119",
            "fax_number": "864-281-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-281-9119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenville Oral Surgery Partners",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Greenville Neurology Consultants, PA
• Greenville Occupational Therapy LLC
• Greenville Ortho LLC
• Greenville Orthotics and Prosthetics, LLC
• Greenville Pediatric Dentistry PA
• Greenville Physcians Imaging Center
• Greenville Plastic Surgery

• Oral and Maxillofacial Surgery (Dentist) in Greenville, SC
• Providers in Greenville, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.