Providence Oral Surgery and Dental Implant Center

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

PROVIDENCE ORAL SURGERY AND DENTAL IMPLANT CENTER

Practice address

102 Waxhaw Professional Park Dr Ste G
Waxhaw, NC 28173-5024

Phone

(732) 547-9101

NPI assigned

Mar 27, 2019

Organization subpart

No

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

Authorized official

Name

Dr. James Parelli, DMD, MDNPI 1346566759

Title

Oral Surgeon/Owner

Phone

(704) 289-8819

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• James Parelli, DMD, MD, MS.ED

  • Oral and Maxillofacial Surgery (Dentist)
  • Waxhaw, NC
  • NPI 1346566759
  NPD Authorized official

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1912468463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WAXHAW PROFESSIONAL PARK DR STE G",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281735024",
            "telephone_number": "704-289-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WAXHAW PROFESSIONAL PARK DR STE G",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281735024",
            "telephone_number": "732-547-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ORAL SURGERY AND DENTAL IMPLANT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "PARELLI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ORAL SURGEON/OWNER",
        "authorized_official_telephone_number": "704-289-8819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Armentha Prosper-Chicas, DDS
• Ellen Pruss
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• Michelle Cox Psyk, MACCCSLP
• Karen Puopolo, OTR/L
• Pure Cardiology, PLLC

• Oral and Maxillofacial Surgery (Dentist) in Waxhaw, NC
• Providers in Waxhaw, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.