Elkhart Oral and Maxillofacial Surgery Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12008926 Issued in IN

Legal business name

ELKHART ORAL AND MAXILLOFACIAL SURGERY INC.

Practice address

117 S Nappanee St
Elkhart, IN 46514-1955

Phone

(574) 293-8211

Fax

(574) 295-8270

NPI assigned

Feb 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey S McBride, DDS

Title

Owner/Partner

Phone

(574) 293-8211

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• David M Fairchild, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Elkhart, IN
  • NPI 1205924651
  NPD (past)

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510704000000",
    "number": "1891973541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 S NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141955",
            "telephone_number": "574-293-8211",
            "fax_number": "574-295-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 S NAPPANEE ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141955",
            "telephone_number": "574-293-8211",
            "fax_number": "574-295-8270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHART ORAL AND MAXILLOFACIAL SURGERY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2017-11-15",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "574-293-8211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12008926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200310500A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elkhart General Hospital, Inc.
• Elkhart General Hospital, Inc.
• Elkhart General Hospital, Inc.
• Elkhart Neurology PC
• Elkhart Ophthalmology, LLC
• Elkhart Pediatric Dentistry LTD
• Elkhart Place Assisted Living LLC
• Elkhart Podiatry Clinic, P.C.
• Elkhart Taxi Dba
• Jessica Eller

• Oral and Maxillofacial Surgery (Dentist) in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.