Oral and Maxillofacial Surgery of the Palm Beaches, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN8638 Issued in FL

Legal business name

ORAL AND MAXILLOFACIAL SURGERY OF THE PALM BEACHES, LLC

Practice address

1920 Palm Beach Lakes Blvd
105
West Palm Beach, FL 33409-3512

Phone

(561) 242-9990

Fax

(561) 242-9994

NPI assigned

Jan 20, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Rolf B Wolfrom

Title

Owner

Phone

(561) 242-9990

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263945600000",
    "number": "1871824581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 PALM BEACH LAKES BLVD",
            "address_2": "105",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093512",
            "telephone_number": "561-242-9990",
            "fax_number": "561-242-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 PALM BEACH LAKES BLVD",
            "address_2": "105",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334093512",
            "telephone_number": "561-242-9990",
            "fax_number": "561-242-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFACIAL SURGERY OF THE PALM BEACHES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A",
        "authorized_official_last_name": "WOLFROM",
        "authorized_official_first_name": "ROLF",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-242-9990",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN8638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.