NPIMap

Organization Active NPI

Chatham Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Pooler, GA
National Provider Identifier
1811640790
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
CHATHAM ORAL SURGERY PC
Doing business as
Chatham Oral Surgery, PC
Practice address
1000 Towne Center Blvd Ste 103
Pooler, GA 31322-4052
Phone
(912) 354-1515
Fax
(912) 354-8181
NPI assigned
Jan 31, 2022
Last updated
Oct 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Michael C Wilson, DMDNPI 1154482297
Title
Owner
Phone
(912) 354-1515

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

1000 Towne Center Blvd Ste 103
Pooler, GA 31322-4052

Mailing address

501 Eisenhower Dr
Savannah, GA 31406-2668
Phone (912) 354-1515

Other names 2

  • Chatham Oral Surgery, PC Doing business as
  • Pooler OMS LLC/87-3972136 Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dwalsh@chathamoralsurgery.com Direct Chatham Oral Surgery, PC

National Provider Directory

National Provider Directory

Locations

1000 Towne Center Blvd
Ste 103
Pooler, GA 31322
Phone (912) 354-1515

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": "1643587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1811640790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062668",
            "telephone_number": "912-354-1515",
            "fax_number": "912-354-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD STE 103",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224052",
            "telephone_number": "912-354-1515",
            "fax_number": "912-354-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATHAM ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-31",
        "last_updated": "2024-10-28",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-354-1515",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dwalsh@chathamoralsurgery.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Chatham Oral Surgery, PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "501 Eisenhower Dr",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314062668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Chatham Oral Surgery, PC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pooler OMS LLC/87-3972136",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.