NPIMap

Organization Active NPI

Oral Surgery& Dental Implant Center of Louisiana

  • Oral and Maxillofacial Surgery (Dentist)
  • Prairieville, LA
National Provider Identifier
1932583358
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
5051 Issued in LA
Legal business name
ORAL SURGERY& DENTAL IMPLANT CENTER OF LOUISIANA
Practice address
16206 Airline Hwy
Prairieville, LA 70769-4248
Phone
(225) 766-3300
Fax
(225) 677-9483
NPI assigned
Jul 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Authorized official

Name
Mr. Vance G Misuraca, DDS
Title
Owner
Phone
(225) 673-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 5051 LA Primary

Addresses

Primary practice location

16206 Airline Hwy
Prairieville, LA 70769-4248

Mailing address

16206 Airline Hwy
Prairieville, LA 70769-4248
Phone (225) 673-1800

National Provider Directory

National Provider Directory

Locations

16206 Airline Hwy
Prairieville, LA 70769
Phone (225) 766-3300

Practitioners & affiliated clinicians

Practitioners 1

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": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1932583358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16206 AIRLINE HWY",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707694248",
            "telephone_number": "225-673-1800",
            "fax_number": "225-677-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16206 AIRLINE HWY",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707694248",
            "telephone_number": "225-766-3300",
            "fax_number": "225-677-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY& DENTAL IMPLANT CENTER OF LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "MISURACA",
        "authorized_official_first_name": "VANCE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-673-1800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "5051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairieville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.