NPIMap

Organization Active NPI

Ub Oral & Maxillofacial Surgery, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Buffalo, NY
National Provider Identifier
1902127335
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
UB ORAL & MAXILLOFACIAL SURGERY, INC
Practice address
3435 Main St, 119 Squire Hall
Buffalo, NY 14214-1421
Phone
(716) 829-6637
Fax
(716) 829-2047
NPI assigned
Jun 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Dr. John H Campbell, DDS, MS
Title
President
Phone
(716) 829-6032

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

3435 Main St, 119 Squire Hall
Buffalo, NY 14214-1421

Mailing address

3435 Main St
119 Squire Hall
Buffalo, NY 14214-3001
Phone (716) 829-6637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110803000315 NY Part B Supplier - Clinic/Group Practice 4385813625 Receives reassigned benefits from 7 practitioners
Practice locations: Buffalo, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1902127335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 MAIN ST",
            "address_2": "119 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142143001",
            "telephone_number": "716-829-6637",
            "fax_number": "716-829-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 MAIN ST, 119 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142141421",
            "telephone_number": "716-829-6637",
            "fax_number": "716-829-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UB ORAL & MAXILLOFACIAL SURGERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-829-6032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.