Northwest Florida Oral and Maxillofacial Surgery, PA

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

DN 6078 Issued in FL

Legal business name

NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY, PA

Practice address

4850 N 9TH Ave Ste 1
Suite 1
Pensacola, FL 32503-2406

Phone

(850) 478-7070

Fax

(850) 476-2513

NPI assigned

Aug 24, 2010

Last updated

Apr 12, 2011By 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. Brett T. Laggan, D.D.SNPI 1629049507

Title

Oral & Maxillofacial Surgeon

Phone

(850) 478-7070

Specialties & licenses 3

Addresses

Other identifiers 2

Tax ID family

Northwest Florida Oral and Maxillofacial Surgery PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northwest Florida Oral and Maxillofacial Surgery, P.a.

  • Oral and Maxillofacial Surgery Clinic/Center
  • Pensacola, FL
  • NPI 1598069239
  NPD tax ID

Practitioners 1

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.

• Brett Thomas Laggan, D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Pensacola, FL
  • NPI 1629049507
  Authorized official Same address or phone

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1699081919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 1",
            "address_2": "SUITE 1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032406",
            "telephone_number": "850-478-7070",
            "fax_number": "850-476-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 1",
            "address_2": "SUITE 1",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032406",
            "telephone_number": "850-478-7070",
            "fax_number": "850-476-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-24",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "LAGGAN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ORAL & MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "850-478-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18924",
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 6078",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18924",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076708500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073210900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rex L. Northup, MD
• Northwest Florida Anesthesia Consultants Inc (North Florida Anesthesia Consultants)
• Northwest Florida Comprehensive Services for Children, Inc.
• Northwest Florida Heart Group PA
• Northwest Florida Oral and Maxillofacial Surgery, P.a.
• Northwest Florida Pathology LLC
• Northwest Florida Physicians Group, LLC
• Northwest Florida Surgical Center, LLC (North Florida Surgery Center)
• Naomi Kirkland Norton, D.M.D.
• Nova Millennium Healthcare, LLC

• Oral and Maxillofacial Surgery Clinic/Center in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; 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.