Bay Area Oral & Maxillofacial Surgery, P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2901013774 Issued in MI

Legal business name

BAY AREA ORAL & MAXILLOFACIAL SURGERY, P.C.

Practice address

4110 Copper Ridge Dr
Suite 210
Traverse City, MI 49684-6722

Phone

(231) 933-1220

Fax

(231) 933-1225

NPI assigned

Aug 22, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Lucinda K Michelin

Title

Practice Administration

Phone

(231) 933-1220

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1972750826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 COPPER RIDGE DR",
            "address_2": "SUITE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846722",
            "telephone_number": "231-933-1220",
            "fax_number": "231-933-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 COPPER RIDGE DR",
            "address_2": "SUITE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846722",
            "telephone_number": "231-933-1220",
            "fax_number": "231-933-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA ORAL & MAXILLOFACIAL SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-22",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "MICHELIN",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATION",
        "authorized_official_telephone_number": "231-933-1220",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901013774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil Ray Bavikatty, MD
• Ashley Lynn Baxter, WELLNESS COACH
• Bay Area Counseling, LLC
• Bay Area Dermatology
• Bay Area Family Care of Traverse City PLC
• Bay Area Urology Associates, PC
• Bay Chiropractic and Massage
• Bay Home Health Care, LLC
• Bay Home Medical & Rehab, Inc.
• Bay Point Family Care, PLLC

• Oral and Maxillofacial Surgery (Dentist) in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.