Christiana Center for Oral & Maxillofacial Surgery, P.a.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

G1-0000952 Issued in DE

Legal business name

CHRISTIANA CENTER FOR ORAL & MAXILLOFACIAL SURGERY, P.A.

Practice address

4133 Ogletown Stanton Rd Ste 200
Newark, DE 19713-4187

Phone

(130) 232-8677

Fax

(023) 195-9543

NPI assigned

May 23, 2006

Last updated

Feb 9, 2023By 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. Eugene Michael Damico III, D.D.S.NPI 1386699379

Title

President

Phone

(302) 292-1600

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

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.

• Eugene Michael Damico III, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Newark, DE
  • NPI 1386699379
  Authorized official Same address or phone

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1740235449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 STANTON OGLETWN RD STE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134187",
            "telephone_number": "302-292-1600",
            "fax_number": "302-319-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 OGLETOWN STANTON RD STE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134187",
            "telephone_number": "130-232-8677",
            "fax_number": "023-195-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIANA CENTER FOR ORAL & MAXILLOFACIAL SURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "DAMICO",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-292-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": "G1-0000952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "000540991",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000189002",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4300241",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS BLUE SHIELD OF DELAWARE",
            "identifier": "199367325",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0116093000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christiana Care Quality Partners (ChristianaCare GoHealth Urgent Care)
• Christiana Care Quality Partners (ChristianaCare GoHealth Urgent Care)
• Christiana Care Quality Partners (ChristianaCare GoHealth Urgent Care)
• Christiana Care Quality Partners (CCQP Behavioral Health)
• Christiana Care Quality Partners (ChristianaCare GoHealth Urgent Care)
• Christiana Center for Womens Wellness, P,a.
• Christiana Chiropractic, LLC
• Christiana Cosmetic Surgery Consultants LLC
• Christiana Dental Associates, LLC
• Christiana Dental Center

• Oral and Maxillofacial Surgery (Dentist) in Newark, DE
• Providers in Newark, DE by specialty
• Oral and Maxillofacial Surgery (Dentist) in Delaware

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