NPIMap

Organization Active NPI

Washington Oral Surgery Center, LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Largo, MD
National Provider Identifier
1891039988
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
14426 Issued in MD
Legal business name
WASHINGTON ORAL SURGERY CENTER, LLC
Doing business as
Woodview Oral Surgery
Practice address
1401 Mercantile LN
Suite 102
Largo, MD 20774-4301
Phone
(301) 341-0041
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Authorized official

Name
Mr. Miko Nkungula
Title
Finance Manager
Phone
(301) 341-0041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 14426 MD Primary

Addresses

Primary practice location

1401 Mercantile LN
Suite 102
Largo, MD 20774-4301

Mailing address

1401 Mercantile LN
Suite 102
Largo, MD 20774-4301
Phone (301) 341-0041

Other names 1

  • Woodview Oral Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Oral Surgery DC2 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.

Locations

1357 Marion Barry Ave SE
Washington, DC 20020

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1891039988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN",
            "address_2": "SUITE 102",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-341-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN",
            "address_2": "SUITE 102",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "301-341-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON ORAL SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "NKUNGULA",
        "authorized_official_first_name": "MIKO",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "301-341-0041",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "14426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodview Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.