Northlake Oral and Facial Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6298 Issued in LA

Legal business name

NORTHLAKE ORAL AND FACIAL SURGERY LLC

Practice address

1271 7TH St
Slidell, LA 70458-2041

Phone

(985) 643-1010

NPI assigned

Oct 1, 2012

Last updated

Nov 2, 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. Nathan Rias Brown, MD, DMDNPI 1336385020

Title

Sole Member

Phone

(985) 643-1010

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Nathan Rias Brown, M.D., D.M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Slidell, LA
  • NPI 1336385020
  Authorized official Same address or phone
• Russell L Westfall, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Slidell, LA
  • NPI 1659340834
  NPD (past)

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1689925539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1271 7TH ST",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582041",
            "telephone_number": "985-643-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 7TH ST",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582041",
            "telephone_number": "985-643-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE ORAL AND FACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "RIAS",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "985-643-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "6298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northlake Interventional Pain Management, LLC
• Northlake Primary Care
• Northlake Radiology Consultants, Apmc
• Northland Hearing Centers Inc (Sears Hearing Aid Centers)
• Northland Hearing Centers, Inc. (Audibel Hearing Healthcare)
• Northshore Audiology, LLC

• Oral and Maxillofacial Surgery (Dentist) in Slidell, LA
• Providers in Slidell, LA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; 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.