Oral Surgery Associates of Wisconsin, S.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL SURGERY ASSOCIATES OF WISCONSIN, S.C.

Practice address

1155 Wittmann Dr
Menasha, WI 54952-3607

Phone

(920) 725-5584

Fax

(920) 725-0160

NPI assigned

Oct 17, 2014

Last updated

Oct 17, 2014By 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

Jeffrey R Lang, DDS

Title

President

Phone

(920) 725-5584

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1700280963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 WITTMANN DR",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549523607",
            "telephone_number": "920-725-5584",
            "fax_number": "920-725-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 WITTMANN DR",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549523607",
            "telephone_number": "920-725-5584",
            "fax_number": "920-725-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY ASSOCIATES OF WISCONSIN, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-725-5584",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.