South Dayton Oral & Maxillofacial Surgery Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30-02437 Issued in OH

Legal business name

SOUTH DAYTON ORAL & MAXILLOFACIAL SURGERY INC

Practice address

7325 Far Hills Ave
Dayton, OH 45459-4415

Phone

(937) 439-1606

NPI assigned

Mar 20, 2015

Organization subpart

No

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

Authorized official

Name

Trent Tucker, DDS, MD

Title

President

Phone

(419) 680-0023

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Michael Andrew Herman, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Dayton, OH
  • NPI 1255527958
  NPD (past)

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1942694583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7325 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7325 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594415",
            "telephone_number": "937-439-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DAYTON ORAL & MAXILLOFACIAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-20",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "TRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-680-0023",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30-02437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ndeye Ndiappaly Soumare, STNA
• South Community Inc.
• South Dayton Acute Care Consultants, Inc
• South Dayton Counseling Center, Inc.
• South Dayton Fammily Dentistry Inc
• Thomas L South, PH.D.
• Rochelle Lenore Southard, RN,CDE
• Sage Southers, CDCA
• Wesley Allen Southers, CDCA
• Southview Hospital Pharmacy

• Oral and Maxillofacial Surgery (Dentist) in Dayton, OH
• Providers in Dayton, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.