NPIMap

Organization Active NPI

Oral Surgery South PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Norwell, MA
National Provider Identifier
1912020512
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
18923 Issued in MA
Legal business name
ORAL SURGERY SOUTH PC
Practice address
80 Washington St
N-51
Norwell, MA 02061-1740
Phone
(781) 871-1677
Fax
(781) 982-4094
NPI assigned
Apr 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John C CataudellaNPI 1770505166
Title
President
Phone
(781) 871-1677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 18923 MA Primary

Addresses

Primary practice location

80 Washington St
N-51
Norwell, MA 02061-1740

Mailing address

80 Washington St
BLD N-51
Norwell, MA 02061-1740
Phone (781) 871-1677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120521000494 MA Part B Supplier - Clinic/Group Practice 7911160437 Receives reassigned benefits from 6 practitioners
Practice locations: Norwell, MA; Plymouth, MA; Quincy, MA

National Provider Directory

National Provider Directory

Locations

80 Washington St
Ste N-51
Norwell, MA 02061
Phone (781) 871-1677

49 Obery St
Plymouth, MA 02360
Phone (508) 746-1614

Practitioners & affiliated clinicians

Practitioners 7

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": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912020512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 WASHINGTON ST",
            "address_2": "BLD N-51",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611740",
            "telephone_number": "781-871-1677",
            "fax_number": "781-982-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 WASHINGTON ST",
            "address_2": "N-51",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611740",
            "telephone_number": "781-871-1677",
            "fax_number": "781-982-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY SOUTH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CATAUDELLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-871-1677",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "18923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.