Midland Oral & Maxillofacial Surgery P.C.

Primary specialty

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

Legal business name

MIDLAND ORAL & MAXILLOFACIAL SURGERY P.C.

Practice address

6112 Merlin CT
Midland, MI 48640

Phone

(989) 839-9979

Fax

(989) 839-9553

NPI assigned

Oct 4, 2005

Last updated

Feb 17, 2020By 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

Shianne Bowers

Title

Financial Dept

Phone

(989) 839-9979

Specialties & licenses 1

Addresses

Other identifiers 12

Other names 1

• Mt. Pleasant Oral & Maxillofacial Surgery Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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.

• Andrew A Afshar, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Midland, MI
  • NPI 1659314888

  Oral and Maxillofacial Surgery

  Medicare reassignment NPD
• Curtis Richard Herzog, DDS, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Midland, MI
  • NPI 1568085264

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1619964715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 MERLIN CT",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486407358",
            "telephone_number": "989-839-9979",
            "fax_number": "989-839-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 MERLIN CT",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48640",
            "telephone_number": "989-839-9979",
            "fax_number": "989-839-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND ORAL & MAXILLOFACIAL SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "SHIANNE",
        "authorized_official_title_or_position": "FINANCIAL DEPT",
        "authorized_official_telephone_number": "989-839-9979"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3487133",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426977",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4297311",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4263986",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4274317",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2993779",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3487124",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4274282",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4274308",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4285455",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2847912",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4274291",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt. Pleasant Oral & Maxillofacial Surgery",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mt. Pleasant Oral & Maxillofacial Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Midland, MI
• Providers in Midland, MI by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.