Owensboro Center for Oral & Maxillofacial Surgery, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4637 Issued in KY

Legal business name

OWENSBORO CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PLLC

Practice address

2816 Veach Rd
Owensboro, KY 42303-6295

Phone

(270) 926-6100

Fax

(270) 926-6195

NPI assigned

Aug 6, 2009

Organization subpart

No

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

Authorized official

Name

Dr. William Douglas Shaver, D.M.D.

Title

Owner

Phone

(270) 926-6100

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1871724914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 VEACH RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423036295",
            "telephone_number": "270-926-6100",
            "fax_number": "270-926-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 VEACH RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423036295",
            "telephone_number": "270-926-6100",
            "fax_number": "270-926-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWENSBORO CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "SHAVER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-926-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "4637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64046378",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033220280",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Owensboro Ambulatory Surgical Facility LTD
• Owensboro Anesthesia Services, PLLC
• Owensboro Behavioral Care PSC
• Owensboro Board of Education
• Owensboro Cancer Center PSC
• Owensboro Dermatology Associates
• Owensboro Dermatology Associates, PSC (Henderson Dermatology)
• Owensboro Endodontics, PSC
• Owensboro Eyecare Center PLLC
• Owensboro Family Eye Care Center PSC

• Oral and Maxillofacial Surgery (Dentist) in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.