Institute of Jaw and Facial Surgery Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

INSTITUTE OF JAW AND FACIAL SURGERY INC

Practice address

4181 Holiday St NW
Canton, OH 44718-2531

Phone

(330) 493-1605

Fax

(330) 493-9308

NPI assigned

Feb 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard N Sundheimer, D.M.D.NPI 1609958198

Title

President

Phone

(330) 493-1605

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 4

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

• Richard Neil Sundheimer, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Canton, OH
  • NPI 1609958198
  Medicare reassignment Authorized official
• David C Ash, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Canton, OH
  • NPI 1205911864
  Medicare reassignment
• Pamela S Amundson, DDS

  • Periodontics
  • Akron, OH
  • NPI 1922189851
  NPD (past)
• Michael R Zetz, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Canton, OH
  • NPI 1215019799
  NPD (past)

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1689647018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4181 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182531",
            "telephone_number": "330-493-1605",
            "fax_number": "330-493-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4181 HOLIDAY ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182531",
            "telephone_number": "330-493-1605",
            "fax_number": "330-493-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF JAW AND FACIAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "SUNDHEIMER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-493-1605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0524534",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0733255",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600433",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amita Ingale
• Deeana Renee Ingol
• Brandy Dunyelle Ingram
• Pertrice Lashay Ingram
• Teleise Ingram
• Integrated Pain Concepts LLC
• Integrated Providers Homecare LLC
• Integrity Auto & Mobility
• Internal Medicine Specialists of Canton Inc
• Iota Care LLC

• Oral and Maxillofacial Surgery (Dentist) in Canton, OH
• Providers in Canton, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

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