NPIMap

Organization Active NPI

Oral and Maxillofacial Surgery, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Brockton, MA
National Provider Identifier
1750458451
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ORAL AND MAXILLOFACIAL SURGERY, INC.
Practice address
830 Oak St
Suite 101W
Brockton, MA 02301-1168
Phone
(508) 586-5445
Fax
(508) 586-1736
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Authorized official

Name
Richard J Catrambone, DMDNPI 1538132956
Title
Owner
Phone
(508) 586-5445

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

830 Oak St
Suite 101W
Brockton, MA 02301-1168

Mailing address

830 Oak St
Suite 101W
Brockton, MA 02301-1168
Phone (508) 586-5445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050617000227 MA Part B Supplier - Clinic/Group Practice 5991749202 Receives reassigned benefits from 7 practitioners
Practice locations: Brockton, MA

National Provider Directory

National Provider Directory

Locations

830 Oak St
Ste 101W
Brockton, MA 02301
Phone (508) 586-5445

Practitioners & affiliated clinicians

Practitioners 10

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": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1750458451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 OAK ST",
            "address_2": "SUITE 101W",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011168",
            "telephone_number": "508-586-5445",
            "fax_number": "508-586-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 OAK ST",
            "address_2": "SUITE 101W",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011168",
            "telephone_number": "508-586-5445",
            "fax_number": "508-586-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFACIAL SURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "CATRAMBONE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-586-5445",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.