Facial & Oral Surgical Solutions, PLLC

Primary specialty

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

License

ME 114524 Issued in FL

Legal business name

FACIAL & ORAL SURGICAL SOLUTIONS, PLLC

Practice address

400 Treemont Dr
Orange City, FL 32763-7978

Phone

(386) 837-1236

Fax

(386) 960-7636

NPI assigned

Jun 30, 2014

Organization subpart

No

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

Authorized official

Name

Stone Rangarajan Thayer, DMD, MD

Title

President

Phone

(386) 837-1236

Specialties & licenses 5

Addresses

Practitioners 1

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

• Shaunda Elyse Kelly, MD, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Birmingham, AL
  • NPI 1659540508
  NPD (past)

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1861807646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 TREEMONT DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637978",
            "telephone_number": "386-837-1236",
            "fax_number": "386-960-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TREEMONT DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327637978",
            "telephone_number": "386-837-1236",
            "fax_number": "386-960-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL & ORAL SURGICAL SOLUTIONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "THAYER",
        "authorized_official_first_name": "STONE",
        "authorized_official_middle_name": "RANGARAJAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-837-1236",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 20469",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 13469",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "FL",
            "license": "DH 17491",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "ME 114524",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "FL",
            "license": "ME 114524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Orange City, FL
• Providers in Orange City, FL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.