NPIMap

Organization Active NPI

Pocono Oral Surgery

  • Oral and Maxillofacial Pathology Dentistry
  • Honesdale, PA
National Provider Identifier
1831393685
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
DS020813L Issued in PA
Legal business name
POCONO ORAL SURGERY
Practice address
1095 Texas Palmyra Hwy
Suite M
Honesdale, PA 18431-7672
Phone
(570) 253-4000
NPI assigned
Jun 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Teresa Niles
Title
Receptionist
Phone
(570) 253-4000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0106X DS020813L PA Primary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0106X DS035287 PA
Oral and Maxillofacial Pathology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0106X BL5871187 PA

Addresses

Primary practice location

1095 Texas Palmyra Hwy
Suite M
Honesdale, PA 18431-7672

Mailing address

1095 Texas Palmyra Hwy
Suite M
Honesdale, PA 18431-7672

National Provider Directory

National Provider Directory

Locations

1095 Texas Palmyra Hwy
Ste M
Honesdale, PA 18431
Phone (570) 253-4000

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1831393685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 TEXAS PALMYRA HWY",
            "address_2": "SUITE M",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184317672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 TEXAS PALMYRA HWY",
            "address_2": "SUITE M",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184317672",
            "telephone_number": "570-253-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCONO ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "NILES",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "570-253-4000"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "PA",
            "license": "DS020813L",
            "primary": true
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "PA",
            "license": "DS035287",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "PA",
            "license": "BL5871187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.