Oral Surgery of Maryland, LLC Jerome Casper Sole MBR

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL SURGERY OF MARYLAND, LLC JEROME CASPER SOLE MBR

Practice address

13600 Baltimore Ave Ste 200
Laurel, MD 20707-9495

Phone

(770) 692-1000

NPI assigned

Apr 27, 2021

Last updated

Apr 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Monica Perkins

Title

Onboarding Specialist

Phone

(678) 244-4844

Specialties & licenses 2

Addresses

Tax ID family

Oral Surgery of Maryland LLC Jerome Casper Sole MBR2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Oral Surgery of Maryland, LLC Jerome Casper Sole MBR

  • Oral and Maxillofacial Surgery Clinic/Center
  • Baltimore, MD
  • NPI 1528628401
  NPD tax ID

Locations

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1811579048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14701",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631784701",
            "telephone_number": "770-692-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13600 BALTIMORE AVE STE 200",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207079495",
            "telephone_number": "770-692-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY OF MARYLAND, LLC JEROME CASPER SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "ONBOARDING SPECIALIST",
        "authorized_official_telephone_number": "678-244-4844"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Laurel, MD
• Providers in Laurel, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.