VC Oral and Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

DI20747 Issued in NJ

Legal business name

VC ORAL AND MAXILLOFACIAL SURGERY

Doing business as

Palisades Oral Surgery

Practice address

1530 Palisade Ave
Fort Lee, NJ 07024-5471

Phone

(201) 585-8082

Fax

(201) 585-0805

NPI assigned

Jul 1, 2010

Last updated

Jul 1, 2010By 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

Mrs. Maria Caputo

Title

Manager

Phone

(201) 585-8282

Specialties & licenses 1

Addresses

Other names 1

• Palisades Oral Surgery Doing business as

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1740591064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "201-585-8082",
            "fax_number": "201-585-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "201-585-8082",
            "fax_number": "201-585-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VC ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-01",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "CAPUTO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-585-8282",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI20747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palisades Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery Clinic/Center in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Oral and Maxillofacial Surgery Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.