The Maxillofacial and Oral Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

THE MAXILLOFACIAL AND ORAL SURGERY CENTER LLC

Practice address

276 Broad St Ste 2
Red Bank, NJ 07701-2003

Phone

(732) 530-1110

NPI assigned

Oct 31, 2023

Organization subpart

No

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

Authorized official

Name

Carly Lubas, RN, BSN, CNOR

Title

Director of Nursing

Phone

(908) 783-3779

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1942073168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 BROAD ST STE 2",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012003",
            "telephone_number": "732-530-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 BROAD ST STE 2",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012003",
            "telephone_number": "732-530-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MAXILLOFACIAL AND ORAL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "LUBAS",
        "authorized_official_first_name": "CARLY",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "908-783-3779",
        "authorized_official_credential": "RN, BSN, CNOR"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.