Mt Oms Specialty Dental Services, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MT OMS SPECIALTY DENTAL SERVICES, PLLC

Practice address

625 Henry Chapple St
Billings, MT 59106-1839

Phone

(406) 259-7438

NPI assigned

Jun 7, 2023

Organization subpart

Yes

Parent organization

MT OMS SPECIALTY DENTAL SERVICES, PLLCAs reported in NPPES

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

Authorized official

Name

Charlotte E Vial

Title

Director of Provider

Phone

(504) 638-0303

Specialties & licenses 1

Addresses

Other names 1

• Summit Oral Surgery & Implant Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mt Oms Specialty Dental Services, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1255007589

  O20220308000682

  Same enrollment
• Mt Oms Specialty Dental Services, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1578329603

  O20220308000682

  Same enrollment

Part of

Mt Oms Specialty Dental Services PLLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Mt Oms Specialty Dental Services, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Billings, MT
  • NPI 1255007589
  NPPES parent name

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698796800000",
    "number": "1780378174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "504-638-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 HENRY CHAPPLE ST",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591061839",
            "telephone_number": "406-259-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT OMS SPECIALTY DENTAL SERVICES, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MT OMS SPECIALTY DENTAL SERVICES, PLLC",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A",
        "authorized_official_last_name": "VIAL",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Oral Surgery & Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Billings, MT
• Providers in Billings, MT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; 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.