Northeast Oral and Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

NORTHEAST ORAL AND MAXILLOFACIAL SURGERY

Practice address

463 Waterbury Court
Suite a
Gahanna, OH 43230

Phone

(614) 471-6600

Fax

(614) 471-6660

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Bruce Allen Fraser, DDS MSNPI 1225177033

Title

Owner

Phone

(614) 471-6600

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce Allen Fraser, DDS, MS

  • Oral and Maxillofacial Pathology Dentistry
  • Columbus, OH
  • NPI 1225177033
  NPD (past) Authorized official
• Gregory C Michaels, D.D.S., M.S.

  • Oral and Maxillofacial Pathology Dentistry
  • Lancaster, OH
  • NPI 1396884805
  NPD (past)
• Chintan I Patel, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Gahanna, OH
  • NPI 1356629711
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790860153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 WATERBURY COURT",
            "address_2": "SUITE A",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "43230",
            "telephone_number": "614-471-6600",
            "fax_number": "614-471-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 WATERBURY COURT",
            "address_2": "SUITE A",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "43230",
            "telephone_number": "614-471-6600",
            "fax_number": "614-471-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-471-6600",
        "authorized_official_credential": "DDS MS"
    },
    "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": []
}

• Nkeng Health Care LLC
• Emmanuel Ngulefac Nkengeh, CNP, FNP
• Larry R. Nolan II, DO
• Scott A Norris, LMT
• Northeast Dermatology and Cosmetic Surgery Center
• Northeast Oral and Maxillofacial Surgery
• Samantha Noth, PA-C
• John W Novotny Jr., DDS
• Nu Wave Acupuncture
• Nurses on Call, Inc

• Oral and Maxillofacial Surgery (Dentist) in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.