Organization Active NPI

Susquehanna Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • York, PA
National Provider Identifier
1851370217
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
SUSQUEHANNA ORAL & MAXILLOFACIAL SURGERY
Practice address
2210 East Market St
York, PA 17402
Phone
(717) 755-9695
Fax
(717) 757-2274
NPI assigned
Jan 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Joanne M Dickerson
Title
Practice Administrator
Phone
(717) 755-9695

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

2210 East Market St
York, PA 17402

Mailing address

2210 East Market St
York, PA 17402
Phone (717) 755-9695

National Provider Directory

National Provider Directory

Locations

2251 Eastern Blvd
Ste 102
York, PA 17402
Phone (717) 559-9695

2210 E Market St
York, PA 17402
Phone (717) 755-9695

2990 Eastern Blvd
York, PA 17402
Phone (717) 755-9695

Practitioners & affiliated clinicians

Practitioners 3

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": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851370217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 EAST MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "17402",
            "telephone_number": "717-755-9695",
            "fax_number": "717-757-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 EAST MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "17402",
            "telephone_number": "717-755-9695",
            "fax_number": "717-757-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "717-755-9695",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.