Glen Burnie Oral Surgery Associates PC

Primary specialty

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

Legal business name

GLEN BURNIE ORAL SURGERY ASSOCIATES PC

Doing business as

Mid-Atlantic Oral Surgery Specialists & Dental Implants

Practice address

677 E Pulaski Hwy Ste D
Elkton, MD 21921-6037

Phone

(917) 701-3581

NPI assigned

Jun 10, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Saman Souri, DMDNPI 1114241452

Title

President

Phone

(917) 701-3581

Specialties & licenses 1

Addresses

Other names 1

• Mid-Atlantic Oral Surgery Specialists & Dental Implants Doing business as

Tax ID family

Glen Burnie Oral Surgery Associates PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Glen Burnie Oral Surgery Associates PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Glen Burnie, MD
  • NPI 1164896395
  NPD tax ID

Locations

Practitioners 1

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

• Saman Souri, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Glen Burnie, MD
  • NPI 1114241452
  NPD Authorized official

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1851968549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 STONE CLIFF DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093733",
            "telephone_number": "917-701-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E PULASKI HWY STE D",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216037",
            "telephone_number": "917-701-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN BURNIE ORAL SURGERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "SOURI",
        "authorized_official_first_name": "SAMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-701-3581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "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": "Mid-Atlantic Oral Surgery Specialists & Dental Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Devon Gill
• Jessica Gillespie
• Mleanen Marcia Gilman, NP-C
• Rhonda Marie Giuliani
• Alexandria Gladle, RN
• Gloria Simonson, MD, LLC
• Panchadcharam Gnaneswaran, M.D.
• Good Care Providers LLC
• Carlo E Gopez, M.D
• Kienda Goslee, LPN

• Oral & Maxillofacial Surgery (D.M.D.) in Elkton, MD
• Providers in Elkton, MD by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.