NPIMap

Organization Active NPI

Warren Oral & Maxillofacial Surgery Center, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Warren, NJ
National Provider Identifier
1770749426
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
02036700 Issued in NJ
Legal business name
WARREN ORAL & MAXILLOFACIAL SURGERY CENTER, LLC
Practice address
31 Mountain Blvd BLDG T
Warren, NJ 07059-5648
Phone
(908) 222-7922
Fax
(908) 222-7923
NPI assigned
Aug 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Authorized official

Name
Dr. Daniel Peter Sullivan, DDSNPI 1649376468
Title
Oral Surgeon/ Partner
Phone
(908) 222-7922

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 SINGLE SPECIALTY GROUP 1223S0112X 02036700 NJ Primary

Addresses

Primary practice location

31 Mountain Blvd BLDG T
Warren, NJ 07059-5648

Mailing address

31 Mountain Blvd BLDG T
Warren, NJ 07059-5648
Phone (908) 222-7922

National Provider Directory

National Provider Directory

Locations

58 Mount Bethel Rd
Warren, NJ 07059

31 Mountain Blvd
Bldg T
Warren, NJ 07059
Phone (908) 222-0070

Practitioners & affiliated clinicians

Practitioners 6

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": "1217548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217548800000",
    "number": "1770749426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MOUNTAIN BLVD BLDG T",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595648",
            "telephone_number": "908-222-7922",
            "fax_number": "908-222-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MOUNTAIN BLVD BLDG T",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595648",
            "telephone_number": "908-222-7922",
            "fax_number": "908-222-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARREN ORAL & MAXILLOFACIAL SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-01",
        "last_updated": "2008-08-01",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "ORAL SURGEON/ PARTNER",
        "authorized_official_telephone_number": "908-222-7922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "02036700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2008; 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.