Evolution Oral Surgery

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

Legal business name

EVOLUTION ORAL SURGERY

Practice address

19851 Observation Dr Ste 320
Germantown, MD 20876-4143

Phone

(301) 916-6000

Fax

(301) 916-6113

NPI assigned

Dec 2, 2020

Last updated

Dec 7, 2020By 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

James Ryan, DDSNPI 1356508493

Title

Oral Surgeon/Owner

Phone

(301) 916-6000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• James Michael Ryan, DDS, MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Germantown, MD
  • NPI 1356508493
  NPD Authorized official
• Furkan Dogan, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Fredericksburg, VA
  • NPI 1689902116
  NPD (past)

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1821693300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19851 OBSERVATION DR STE 320",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764143",
            "telephone_number": "301-916-6000",
            "fax_number": "301-916-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19851 OBSERVATION DR STE 320",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764143",
            "telephone_number": "301-916-6000",
            "fax_number": "301-916-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ORAL SURGEON/OWNER",
        "authorized_official_telephone_number": "301-916-6000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356508493",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Pathology Dentistry in Germantown, MD
• Providers in Germantown, MD by specialty
• Oral and Maxillofacial Pathology Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.