Louisiana Oral & Implant Surgery

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

LOUISIANA ORAL & IMPLANT SURGERY

Doing business as

Louisiana Oral and Implant Surgery

Practice address

4720 Lake Street
Lake Charles, LA 70605

Phone

(337) 888-4771

Fax

(337) 888-4772

NPI assigned

Sep 18, 2019

Last updated

Dec 23, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nickolas Maskas, DDS, MDNPI 1679913222

Title

Oral and Maxillofacial Surgeon/Owne

Phone

(337) 888-4771

Specialties & licenses 1

Addresses

Other names 1

• Louisiana Oral and Implant Surgery Doing business as

Locations

Practitioners 1

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.

• Nickolas Stanley Maskas, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Charles, LA
  • NPI 1679913222
  NPD Authorized official

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1932759271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 LAKE STREET",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-888-4771",
            "fax_number": "337-888-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 LAKE STREET",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-888-4771",
            "fax_number": "337-888-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA ORAL & IMPLANT SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "MASKAS",
        "authorized_official_first_name": "NICKOLAS",
        "authorized_official_title_or_position": "ORAL AND MAXILLOFACIAL SURGEON/OWNE",
        "authorized_official_telephone_number": "337-888-4771",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisiana Oral and Implant Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Louisiana Oral and Implant Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery Clinic/Center in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.