Wyoming Valley Oral Surgery PLLC

Primary specialty

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

Legal business name

WYOMING VALLEY ORAL SURGERY PLLC

Practice address

550 3Rd Ave Ste 1
Kingston, PA 18704-5806

Phone

(570) 288-9070

Fax

(570) 288-4201

NPI assigned

Nov 6, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Brian Mitchell, DDSNPI 1619407608

Title

Owner

Phone

(570) 288-9070

Specialties & licenses 1

Addresses

Other names 1

• Callahan and Bergey Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 4

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

• Brian Mitchell, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Kingston, PA
  • NPI 1619407608
  Medicare reassignment Care Compare group NPD Authorized official
• William F Bergeron III, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Kingston, PA
  • NPI 1427514314
  Medicare reassignment Care Compare group NPD
• David Alan Bergey, D.D.S.01

  • Oral and Maxillofacial Surgery (Dentist)
  • Kingston, PA
  • NPI 1386618643
  Medicare reassignment NPD
• Miriam Caroline Omalley, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Kingston, PA
  • NPI 1154419042
  Medicare reassignment NPD

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1831962323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 3RD AVE STE 1",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045806",
            "telephone_number": "570-288-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 3RD AVE STE 1",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045806",
            "telephone_number": "570-288-9070",
            "fax_number": "570-288-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING VALLEY ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-288-9070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Callahan and Bergey Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allen Woods, D.M.D.
• Wyoming Valley Alcohol and Drug Services Inc
• Wyoming Valley Alcohol and Drug Services Inc
• Wyoming Valley Foot Associates P C
• Wyoming Valley Internal Medicine
• Wyoming Valley Pharmacy Inc
• Wyoming Valley West
• Mary Ann Katherine Yenason, PHD
• Brittany Julie Young
• Darnetta Yusko, CRNP, IBCLC

• Oral & Maxillofacial Surgery (D.M.D.) in Kingston, PA
• Providers in Kingston, PA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.