Legacy Oral and Facial Surgery Center PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

LEGACY ORAL AND FACIAL SURGERY CENTER PC

Practice address

2521 Jackson Ave
Ann Arbor, MI 48103-3818

Phone

(734) 210-0677

Fax

(734) 210-1273

NPI assigned

Jul 14, 2021

Last updated

Jul 14, 2021By 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

Dalbert W Fear Jr., DDS.,MS.

Title

Owner

Phone

(734) 395-9532

Specialties & licenses 1

Addresses

Electronic endpoints 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.

• Alena Marie Fear, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Ann Arbor, MI
  • NPI 1427445295
  NPD
• Dalbert W. Fear, Jr., DDS, MS

  • Oral and Maxillofacial Pathology Dentistry
  • Ann Arbor, MI
  • NPI 1194842500
  NPD

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1841862232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 CREEKSIDE CT",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059570",
            "telephone_number": "734-395-9532",
            "fax_number": "740-919-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 JACKSON AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481033818",
            "telephone_number": "734-210-0677",
            "fax_number": "734-210-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY ORAL AND FACIAL SURGERY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "FEAR",
        "authorized_official_first_name": "DALBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-395-9532",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS.,MS."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@a2legacyofsc.com",
            "affiliation": "N",
            "address_1": "2521 Jackson Ave",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481033818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sujin Lee
• Wei-Wei Lee, MD
• Agata Ewa Lefere, DMD
• Kaitlin Grace Leffler
• Legacy Home Health Care, Inc
• Daliyah Legare
• Marie Anna Leginza, NP
• Adaryll Legrant Jr.
• Haley Svrcina Lehman
• Tatyana Lehman, NP

• Oral and Maxillofacial Surgery Clinic/Center in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.