Advanced Faces, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN14869 Issued in FL

Legal business name

ADVANCED FACES, LLC

Practice address

855 Oakley Seaver Dr
Clermont, FL 34711-1968

Phone

(352) 242-0627

Fax

(352) 242-0648

NPI assigned

Apr 13, 2007

Last updated

Oct 18, 2012By 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. Christopher T Johnson, DMDNPI 1467498253

Title

Owner

Phone

(352) 242-0627

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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.

• Christopher T Johnson, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Clermont, FL
  • NPI 1467498253
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1669697025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111968",
            "telephone_number": "352-242-0627",
            "fax_number": "352-242-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111968",
            "telephone_number": "352-242-0627",
            "fax_number": "352-242-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FACES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-242-0627",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN14869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Banicio Junior Adonis
• Myrlene Adonis
• Advance Chiropractic PLLC
• Advanced 3D Imaging, LLC
• Advanced Clinical Laboratories, Inc. (Vista Clinical)
• Advanced Imaging Center of Clermont, Inc.
• Advanced Imaging Center of Leesburg,LLC (Advanced Imaging Center of Clermont)
• Advanced Infectious Diseases &Wound Care Specialist LLC
• Advanced Integrated Pain & Spine Solutions
• Advanced Kidney Care of Central

• Oral and Maxillofacial Surgery (Dentist) in Clermont, FL
• Providers in Clermont, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.