NPIMap

Organization Active NPI

Maxilla LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Collegeville, PA
National Provider Identifier
1942082250
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
MAXILLA LLC
Practice address
555 Second Ave Ste E-100
Collegeville, PA 19426-3622
Phone
(610) 409-9660
NPI assigned
Oct 20, 2023
Organization subpart
Yes
Parent organization
PA ORAL SURGERY LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Authorized official

Name
Dr. Michael Bianchi, DDS, FACSNPI 1285663534
Title
President
Phone
(610) 527-3110

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

555 Second Ave Ste E-100
Collegeville, PA 19426-3622

Mailing address

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3201
Phone (610) 527-3110

National Provider Directory

National Provider Directory
Part of
Maxilla LLC

Locations

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (610) 527-3110

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697760000000",
    "number": "1942082250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103201",
            "telephone_number": "610-527-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SECOND AVE STE E-100",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194263622",
            "telephone_number": "610-409-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXILLA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PA ORAL SURGERY LTD",
        "enumeration_date": "2023-10-20",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A",
        "authorized_official_last_name": "BIANCHI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-527-3110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, FACS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.