Organization Active NPI

Coastal Oral Surgery Group, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Toms River, NJ
National Provider Identifier
1790800423
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
COASTAL ORAL SURGERY GROUP, LLC
Practice address
9 Hospital Dr
Suite 6
Toms River, NJ 08755-6425
Phone
(732) 286-1199
Fax
(732) 286-2303
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Sharlene Marple
Title
Administrator
Phone
(732) 286-1199

Specialties & licenses 1

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

Addresses

Primary practice location

9 Hospital Dr
Suite 6
Toms River, NJ 08755-6425

Mailing address

9 Hospital Dr
Suite 6
Toms River, NJ 08755-6425
Phone (732) 286-1199

Other names 1

  • Coastal Oral Surgery, PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110510000071 NJ Part B Supplier - Clinic/Group Practice 9133305196 Receives reassigned benefits from 4 practitioners
Practice locations: Brick, NJ; Sea Girt, NJ; Toms River, NJ
O20240610000851 NJ Part B Supplier - Clinic/Group Practice 4789126434 Receives reassigned benefits from 3 practitioners
Practice locations: Brick, NJ; Toms River, NJ

National Provider Directory

National Provider Directory

Locations

1608 Route 88 W
Ste 101
Brick, NJ 08724
Phone (732) 840-4600

2130 Route 35
Ste 112
Sea Girt, NJ 08750
Phone (732) 974-0680

9 Hospital Dr
Ste A6
Toms River, NJ 08755
Phone (732) 240-0322

9 Hospital Dr
Ste 6
Toms River, NJ 08755
Phone (732) 286-1199

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1790800423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HOSPITAL DR",
            "address_2": "SUITE 6",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087556425",
            "telephone_number": "732-286-1199",
            "fax_number": "732-286-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HOSPITAL DR",
            "address_2": "SUITE 6",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087556425",
            "telephone_number": "732-286-1199",
            "fax_number": "732-286-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ORAL SURGERY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "MARPLE",
        "authorized_official_first_name": "SHARLENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-286-1199"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Oral Surgery, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.