Oral Surgery Group of Coastal Georgia, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN013242 Issued in GA

Legal business name

ORAL SURGERY GROUP OF COASTAL GEORGIA, LLC

Practice address

506 US Highway 80 W
Pooler, GA 31322

Phone

(912) 330-9229

Fax

(912) 330-9220

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Stephen James, CFO

Title

Cfo

Phone

(502) 254-8500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1982722013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 US HIGHWAY 80 W",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222104",
            "telephone_number": "912-330-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 US HIGHWAY 80 W",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "31322",
            "telephone_number": "912-330-9229",
            "fax_number": "912-330-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY GROUP OF COASTAL GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "502-254-8500",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN013242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Telisha Odums-Oladele, LPC, ED.S
• Olivia Oglesby
• Ohana Spine & Ortho Care
• Amber Lynn Oland, OTR/L
• Oral Maxillofacial Surgery Group of Coastal Georgia
• Daniel Luis Orsini, SFIDC
• Ortho Sport and Spine Physicians Pooler
• Orthopedic Center PC
• Chasidy Ortiz, RBT
• Katherine Victoria Osborne, PT, DPT

• Oral and Maxillofacial Surgery (Dentist) in Pooler, GA
• Providers in Pooler, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.