Belleair Oral Surgery and Implants, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN15139 Issued in FL

Legal business name

BELLEAIR ORAL SURGERY AND IMPLANTS, PLLC

Practice address

100 Indian Rocks Rd N
Suite 12
Belleair Bluffs, FL 33770-1778

Phone

(727) 581-3300

Fax

(727) 581-3302

NPI assigned

Dec 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ralph Mark Eichstaedt, D.D.S.

Title

President/Oral Surgeon

Phone

(727) 581-3300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396224000000",
    "number": "1720380207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 INDIAN ROCKS RD N",
            "address_2": "SUITE 12",
            "city": "BELLEAIR BLUFFS",
            "state": "FL",
            "postal_code": "337701778",
            "telephone_number": "727-581-3300",
            "fax_number": "727-581-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 INDIAN ROCKS RD N",
            "address_2": "SUITE 12",
            "city": "BELLEAIR BLUFFS",
            "state": "FL",
            "postal_code": "337701778",
            "telephone_number": "727-581-3300",
            "fax_number": "727-581-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEAIR ORAL SURGERY AND IMPLANTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2014-03-31",
        "status": "A",
        "authorized_official_last_name": "EICHSTAEDT",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT/ORAL SURGEON",
        "authorized_official_telephone_number": "727-581-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN15139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Belleair Bluffs, FL
• Providers in Belleair Bluffs, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.