NPIMap

Organization Active NPI

Oral & Maxillofacial Surgery Associates of Charleston

  • Specialist
  • Charleston, SC
National Provider Identifier
1720029853
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ORAL & MAXILLOFACIAL SURGERY ASSOCIATES OF CHARLESTON
Practice address
2320 Cosgrove Ave
Charleston, SC 29405-7644
Phone
(843) 554-5003
Fax
(843) 745-0003
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Lon R Doles, DDSNPI 1255491692
Title
President
Phone
(843) 554-5003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X SC Primary

Addresses

Primary practice location

2320 Cosgrove Ave
Charleston, SC 29405-7644

Mailing address

2320 Cosgrove Ave
Charleston, SC 29405-7644
Phone (843) 554-5003

Other identifiers 1

IdentifierTypeStateIssuer
ZA9621MedicaidSC

National Provider Directory

National Provider Directory

Locations

2320 Cosgrove Ave
North Charleston, SC 29405
Phone (843) 554-5003

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1720029853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 COSGROVE AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294057644",
            "telephone_number": "843-554-5003",
            "fax_number": "843-745-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 COSGROVE AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294057644",
            "telephone_number": "843-554-5003",
            "fax_number": "843-745-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL & MAXILLOFACIAL SURGERY ASSOCIATES OF CHARLESTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DOLES",
        "authorized_official_first_name": "LON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-554-5003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9621",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.