Shoreline Oral & Maxillofacial Surgeons, PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7920 Issued in DE

Legal business name

SHORELINE ORAL & MAXILLOFACIAL SURGEONS, PC

Practice address

1480 Boston Post Rd
Old Saybrook, CT 06475-1750

Phone

(860) 388-5745

Fax

(860) 388-2145

NPI assigned

Oct 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Andrew J. Kressley, DMDNPI 1225065295

Title

President

Phone

(860) 388-5745

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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.

• Andrew J Kressley, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Old Saybrook, CT
  • NPI 1225065295

  Oral and Maxillofacial Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1679761142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 BOSTON POST ROAD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751750",
            "telephone_number": "860-388-5745",
            "fax_number": "860-388-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 BOSTON POST RD",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751750",
            "telephone_number": "860-388-5745",
            "fax_number": "860-388-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE ORAL & MAXILLOFACIAL SURGEONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "KRESSLEY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-388-5745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": "7920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stephanie R Settevendemie, APRN
• Larry Weston Shobe, LCSW
• Shoreline Digestive Health Center
• Shoreline Modern Dental LLC
• Shoreline Pediatric Neuropsychological Services, LLC
• Shoreline Therapy Center of Southeast CT LLC
• David J Sliva, DMD
• Heather Slocombe, RDH
• Angela Menta Snelling, MA LPC

• Oral and Maxillofacial Surgery (Dentist) in Old Saybrook, CT
• Providers in Old Saybrook, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.