NPIMap

Organization Active NPI

Commonwealth Oral and Maxillofacial Surgery, PSC

Doing business as Commonwealth Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Louisville, KY
National Provider Identifier
1922480250
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
8588 Issued in KY
Legal business name
COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY, PSC
Doing business as
Commonwealth Oral Surgery
Practice address
6520 Glenridge Park PL
Suite 7
Louisville, KY 40222-3455
Phone
(502) 423-7822
Fax
(502) 423-7830
NPI assigned
Jun 23, 2015
Last updated
Jun 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Authorized official

Name
Dr. Timothy Acord, D.D.S.NPI 1194850875
Title
Owner, President
Phone
(502) 423-7822

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 8588 KY Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 8588 KY

Addresses

Primary practice location

6520 Glenridge Park PL
Suite 7
Louisville, KY 40222-3455

Mailing address

6520 Glenridge Park PL
Suite 7
Louisville, KY 40222-3455
Phone (502) 423-7822

Other names 1

  • Commonwealth Oral Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

6520 Glenridge Park Pl
Ste 7
Louisville, KY 40222
Phone (502) 423-7822

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1922480250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 GLENRIDGE PARK PL",
            "address_2": "SUITE 7",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223455",
            "telephone_number": "502-423-7822",
            "fax_number": "502-423-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 GLENRIDGE PARK PL",
            "address_2": "SUITE 7",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223455",
            "telephone_number": "502-423-7822",
            "fax_number": "502-423-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH ORAL AND MAXILLOFACIAL SURGERY, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "ACORD",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "502-423-7822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "8588",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KY",
            "license": "8588",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.