Oral & Maxillofacial Surgeons Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL & MAXILLOFACIAL SURGEONS INC

Practice address

970 W Wooster St
Suite 126
Bowling Green, OH 43402-2643

Phone

(419) 353-2100

Fax

(419) 353-6606

NPI assigned

Aug 16, 2005

Last updated

Jul 21, 2022By 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

Patrick J McCabe, DDS

Title

President

Phone

(419) 517-2100

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Harbor Light Oral & Maxillofacial Surgeons Inc Other name

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Oral & Maxillofacial Surgeons Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Wauseon, OH
  • NPI 1013680925

  O20040205001344

  Same enrollment
• Oral & Maxillofacial Surgeons Inc

  dba Harbor Light Oral & Maxillofacial Surgeons Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Toledo, OH
  • NPI 1164414355

  O20040205001344

  Same enrollment
• Oral & Maxillofacial Surgeons Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Toledo, OH
  • NPI 1326030503

  O20040205001344

  Same enrollment

Tax ID family

Oral Maxillofacial Surg in4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Oral & Maxillofacial Surgeons Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Wauseon, OH
  • NPI 1013680925
  NPD tax ID
• Oral & Maxillofacial Surgeons Inc

  dba Harbor Light Oral & Maxillofacial Surgeons Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Toledo, OH
  • NPI 1164414355
  NPD tax ID
• Oral & Maxillofacial Surgeons Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Toledo, OH
  • NPI 1326030503
  NPD tax ID

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982696175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 NANTUCKETT DR STE A",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233194",
            "telephone_number": "419-517-2100",
            "fax_number": "419-517-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 W WOOSTER ST",
            "address_2": "SUITE 126",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022643",
            "telephone_number": "419-353-2100",
            "fax_number": "419-353-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL & MAXILLOFACIAL SURGEONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2022-07-21",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "MCCABE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-517-2100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DB2868",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2241489",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2241498",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor Light Oral & Maxillofacial Surgeons Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Bowling Green, OH
• Providers in Bowling Green, 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 Jul 21, 2022; 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.