Montgomery Oral & Facial Surgery, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11822 Issued in MD

Legal business name

MONTGOMERY ORAL & FACIAL SURGERY, LLC

Practice address

4701 Randolph Rd
G10
Rockville, MD 20852-2257

Phone

(301) 468-0020

NPI assigned

Feb 23, 2012

Last updated

Feb 23, 2012By 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

Dr. Leonard MerloNPI 1346245198

Title

Owner

Phone

(301) 468-0020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Tax ID family

Montgomery Oral Facial Surgery LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Montgomery Oral & Facial Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Rockville, MD
  • NPI 1649676503
  NPD tax ID

Locations

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.

• Leonard A Merlo, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Rockville, MD
  • NPI 1346245198

  DC

  Medicare reassignment NPD Authorized official
• Farzaneh Rostami, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Washington, DC
  • NPI 1295055762
  Medicare reassignment NPD

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1942573860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD",
            "address_2": "G10",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 RANDOLPH RD",
            "address_2": "G10",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522257",
            "telephone_number": "301-468-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY ORAL & FACIAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "MERLO",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-468-0020",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "11822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montgomery Medical Associates, P.C.
• Montgomery Medical Services
• Montgomery Oncology Care and Hematology PC
• Montgomery Oral & Facial Surgery
• Montgomery Oral & Facial Surgery, LLC
• Montgomery Pediatric Dental Partners, LLC
• Montgomery Recovery Services, Inc
• Montgomery Surgery Center Limited Partnership
• Montgomery Therapy, LLC
• Montgomery Women's Medical Center, P.C. (Montgomery Fertility Center)

• Oral and Maxillofacial Surgery (Dentist) in Rockville, MD
• Providers in Rockville, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.