NPIMap

Organization Active NPI

Dental Management Group LLC

Doing business as Oral Surgery Center - Medical

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Aurora, CO
National Provider Identifier
1700388592
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
DENTAL MANAGEMENT GROUP LLC
Doing business as
Oral Surgery Center - Medical
Practice address
11246 E Mississippi Ave
Aurora, CO 80012-3202
Phone
(303) 344-0810
NPI assigned
Mar 7, 2018
Last updated
May 9, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL MANAGEMENT GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Authorized official

Name
Yasser SedhomNPI 1811200686
Title
Business Director
Phone
(303) 344-0810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X NU Primary

Addresses

Primary practice location

11246 E Mississippi Ave
Aurora, CO 80012-3202

Mailing address

11246 E Mississippi Ave
Aurora, CO 80012-3202
Phone (303) 344-0810

Other identifiers 1

IdentifierTypeStateIssuer
02066165MedicaidCO

Other names 1

  • Oral Surgery Center - Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Management Group LLC4 organizations share this tax ID, including this one
Part of
Dental Management Group LLC

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1700388592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11246 E MISSISSIPPI AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123202",
            "telephone_number": "303-344-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11246 E MISSISSIPPI AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123202",
            "telephone_number": "303-344-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL MANAGEMENT GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL MANAGEMENT GROUP LLC",
        "enumeration_date": "2018-03-07",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "SEDHOM",
        "authorized_official_first_name": "YASSER",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "303-344-0810"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02066165",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oral Surgery Center - Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.