Longhorn Ranch Oral and Maxillofacial Surgery PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901020237 Issued in MI

Legal business name

LONGHORN RANCH ORAL AND MAXILLOFACIAL SURGERY PC

Practice address

3610 Capital Ave SW
Battle Creek, MI 49015-9354

Phone

(269) 965-1339

NPI assigned

May 24, 2016

Organization subpart

No

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

Authorized official

Name

Jonathan Bonnet, MD, DDSNPI 1447679444

Title

President

Phone

(214) 226-3980

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

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

• Jonathan Bonnet, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Battle Creek, MI
  • NPI 1447679444

  Oral and Maxillofacial Surgery

  Medicare reassignment NPD Authorized official
• James M Grubka, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Battle Creek, MI
  • NPI 1578648648
  NPD (past)
• Michael R Loudon, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Battle Creek, MI
  • NPI 1992880066
  NPD (past)

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1831546407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 CAPITAL AVE SW",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490159354",
            "telephone_number": "269-965-1339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 CAPITAL AVE SW",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490159354",
            "telephone_number": "269-965-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGHORN RANCH ORAL AND MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "BONNET",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-226-3980",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901020237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth A Lombardi, MD
• Lauren Kai London
• Marquita London, M.D.
• David Harley Long, D.D.S.
• Shannon Long, LMSW-C
• Keng Lor, D.M.D.
• Cora J Lorenz, M.A., TLLP
• Cheryl Lynn Loss, M.A.
• Michael R Loudon, DDS
• Patricia Ann Loudon

• Oral and Maxillofacial Surgery (Dentist) in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.