NPIMap

Organization Active NPI

Midland Oral Surgery and Implant Centers, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Tinley Park, IL
National Provider Identifier
1801804182
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
MIDLAND ORAL SURGERY AND IMPLANT CENTERS, LTD
Practice address
7625 159TH St
Tinley Park, IL 60477-1492
Phone
(708) 429-4770
Fax
(708) 429-9685
NPI assigned
Aug 3, 2006
Last updated
Aug 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Authorized official

Name
Dr. Edward L Kasper, DDSNPI 1841208147
Title
Senior Partner
Phone
(708) 429-4770

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 Primary

Addresses

Primary practice location

7625 159TH St
Tinley Park, IL 60477-1492

Mailing address

7625 159TH St
Tinley Park, IL 60477-1492
Phone (708) 429-4770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050923000379 IL Part B Supplier - Clinic/Group Practice 1355375825 Receives reassigned benefits from 2 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frankfort, IL; Oak Lawn, IL; Tinley Park, IL

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

7625 W 159th St
Tinley Park, IL 60477
Phone (708) 429-4770

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1801804182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 159TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771492",
            "telephone_number": "708-429-4770",
            "fax_number": "708-429-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 159TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604771492",
            "telephone_number": "708-429-4770",
            "fax_number": "708-429-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND ORAL SURGERY AND IMPLANT CENTERS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "KASPER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "708-429-4770",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; 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.