Elkins Park Oral Surgery, Inc

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

DS037551 Issued in PA

Legal business name

ELKINS PARK ORAL SURGERY, INC

Practice address

7900 Old York Rd
115 A
Elkins Park, PA 19027-2318

Phone

(215) 635-0808

NPI assigned

Mar 5, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Mathew Cherian, DDS

Title

President

Phone

(215) 663-1223

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elkins Park Dental Specialist Doing business as

Locations

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1689915316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 OLD YORK RD",
            "address_2": "115 A",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272318",
            "telephone_number": "215-635-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 OLD YORK RD",
            "address_2": "115 A",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272318",
            "telephone_number": "215-635-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKINS PARK ORAL SURGERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-05",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "CHERIAN",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-663-1223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "PA",
            "license": "DS037551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022041470033",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elkins Park Dental Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elkins Park Dental Innovations PC
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• Elkins Park Orthodontics PC
• Elkins Park Orthodontist
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• Elkins Park Physical Therapy LLC
• Julius Ellison, MD

• Oral and Maxillofacial Pathology Dentistry in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Oral and Maxillofacial Pathology Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.