King Oral Surgery Group

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

14203 Issued in MD

Legal business name

KING ORAL SURGERY GROUP

Practice address

11885 Holly LN Ste 2
Waldorf, MD 20601-3187

Phone

(301) 645-4555

NPI assigned

Nov 17, 2010

Organization subpart

No

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

Authorized official

Name

Micheal King

Title

President

Phone

(615) 293-3744

Specialties & licenses 1

Addresses

Other names 1

• n/a Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael A King, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • White Plains, MD
  • NPI 1194845222
  NPD (past)

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1679875033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6368 COVENTRY WAY STE 197",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11885 HOLLY LN STE 2",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206013187",
            "telephone_number": "301-645-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING ORAL SURGERY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-293-3744"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "14203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nimesh Khatri, M.D.
• Laura Kijewski, BSW, LSWA
• Sarah Kimball, PNP
• Mariesa Kinch, CRNP
• Kindred Services, Inc.
• Deidre Cheryl King-Woodward
• Beata Kinsey, LCPC
• Marian E. Kirk, P.T.
• John Brian Kirscht Jr., PTA
• Linda Kline-Lau, MA, NCC

• Oral and Maxillofacial Surgery (Dentist) in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.