East Columbus Oral Surgery Specialists Inc.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

30022741 Issued in OH

Legal business name

EAST COLUMBUS ORAL SURGERY SPECIALISTS INC.

Practice address

6555 E Broad St.
Columbus, OH 43213

Phone

(614) 427-0400

Fax

(614) 427-0735

NPI assigned

Apr 18, 2016

Organization subpart

No

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

Authorized official

Name

Douglas Von Kaenel, D.D.S.NPI 1083713408

Title

Owner / Surgeon

Phone

(614) 427-0400

Specialties & licenses 2

Addresses

Other names 1

• East Columbus Oral Surgery Specialists Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas Alan Vonkaenel, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Heath, OH
  • NPI 1083713408
  NPD (past) Authorized official
• Andrew Robert Mullendore, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbus, OH
  • NPI 1649214164

  Oral & Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1831543701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6555 E BROAD ST.",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43213",
            "telephone_number": "614-427-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6555 E BROAD ST.",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43213",
            "telephone_number": "614-427-0400",
            "fax_number": "614-427-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COLUMBUS ORAL SURGERY SPECIALISTS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "VON KAENEL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER / SURGEON",
        "authorized_official_telephone_number": "614-427-0400",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "30022741",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OH",
            "license": "30023253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Columbus Oral Surgery Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tahira Lashea Easley, LISW
• William Nathan Easley, CPRS
• East Broad Chiropractic, Inc.
• East Broad Physical Rehab LLC
• East Columbus Anesthesia LLC
• East Columbus Orthopaedics Inc.
• East Columbus Orthopedic Medicine & Pain Center, Inc
• East Columbus Periodontics LLC
• East Columbus Surgery Center LLC
• East Columbus Surgery Center LLC

• Oral & Maxillofacial Surgery (D.M.D.) in Columbus, OH
• Providers in Columbus, OH by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.