Organization Active NPI

Montville Oral Surgery Associates, L.L.C.

  • Oral and Maxillofacial Surgery Clinic/Center
  • Montville, NJ
National Provider Identifier
1669593521
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
MONTVILLE ORAL SURGERY ASSOCIATES, L.L.C.
Practice address
150 River Rd Ste H2
Montville, NJ 07045-8922
Phone
(973) 316-5757
Fax
(973) 331-1443
NPI assigned
Apr 2, 2007
Last updated
May 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Ms. Jean D McGowan
Title
Office Manager
Phone
(973) 316-5757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X NJ Primary

Addresses

Primary practice location

150 River Rd Ste H2
Montville, NJ 07045-8922

Mailing address

150 River Rd Ste H2
Montville, NJ 07045-8922
Phone (973) 316-5757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090323000298 NJ Part B Supplier - Clinic/Group Practice 5395802185 Receives reassigned benefits from 2 practitioners
Practice locations: Montville, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1669593521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 RIVER RD STE H2",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070458922",
            "telephone_number": "973-316-5757",
            "fax_number": "973-331-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 RIVER RD STE H2",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070458922",
            "telephone_number": "973-316-5757",
            "fax_number": "973-331-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTVILLE ORAL SURGERY ASSOCIATES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "MCGOWAN",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-316-5757",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.