Granite State Oral Surgery PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3025 Issued in NH

Legal business name

GRANITE STATE ORAL SURGERY PLLC

Practice address

80 Nashua Rd
Building C
Londonderry, NH 03053-3426

Phone

(603) 432-3308

Fax

(603) 425-6165

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Salman Ayub Malik, D.M.D., M.D.NPI 1417977737

Title

Owner

Phone

(603) 432-3308

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

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

• Salman Malik, D.M.D., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Londonderry, NH
  • NPI 1417977737
  NPD (past) Authorized official

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801097654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 NASHUA RD",
            "address_2": "BUILDING C",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533426",
            "telephone_number": "603-432-3308",
            "fax_number": "603-425-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 NASHUA RD",
            "address_2": "BUILDING C",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533426",
            "telephone_number": "603-432-3308",
            "fax_number": "603-425-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE STATE ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "SALMAN",
        "authorized_official_middle_name": "AYUB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-432-3308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D., M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NH",
            "license": "3025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1417977737",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30312701",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID",
            "identifier": "0206381Y0NH01",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan David Goodwin, BCBA
• Victoria Gorveatt, APRN, PMHNP-BC, FNP
• Pamela R Goyette, OTR
• Sara Gramstorff
• Granite State Gastrointestinal Consultants PLLC
• Granite Strategic Transportation
• Jessica Greene
• Tammie L Groleau, P.T.
• Shanon H Gruchot, MD
• Jennifer Donna Guinazzo

• Oral and Maxillofacial Surgery (Dentist) in Londonderry, NH
• Providers in Londonderry, NH by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Hampshire

• 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.