Shenandoah Oral & Maxillofacial Surgery Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401006414 Issued in VA

Legal business name

SHENANDOAH ORAL & MAXILLOFACIAL SURGERY INC

Practice address

170 Garber LN
Winchester, VA 22602-4386

Phone

(540) 667-0100

Fax

(540) 667-0121

NPI assigned

May 24, 2013

Organization subpart

No

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

Authorized official

Name

Tara Ann Fugate

Title

Practice Administrator

Phone

(703) 897-8983

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Farnaz Valaei, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • McLean, VA
  • NPI 1518489020
  NPD (past)
• Richard Ke Ming Wang, DMD MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Alexandria, VA
  • NPI 1053489088
  NPD (past)

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568764800000",
    "number": "1972940393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 GARBER LN",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226024386",
            "telephone_number": "540-667-0100",
            "fax_number": "540-667-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GARBER LN",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226024386",
            "telephone_number": "540-667-0100",
            "fax_number": "540-667-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH ORAL & MAXILLOFACIAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-24",
        "last_updated": "2019-09-18",
        "status": "A",
        "authorized_official_last_name": "FUGATE",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "703-897-8983"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401006414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shenandoah Optical Inc. (Winchester Optical)
• Shenandoah Plastic Surgery
• Shenandoah Professional Counseling, LLC
• Shenandoah Smiles PC
• Shenandoah Soundstart, LLC
• Shenandoah Spinecare, PLLC. (Shenandoah SpineCare)

• Oral and Maxillofacial Surgery (Dentist) in Winchester, VA
• Providers in Winchester, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.