NPIMap

Organization Active NPI

Oral Surgery Center of Kokomo LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Kokomo, IN
National Provider Identifier
1992124879
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12012039A Issued in IN
Legal business name
ORAL SURGERY CENTER OF KOKOMO LLC
Practice address
3415 S Lafountain St
Suite H
Kokomo, IN 46902-3802
Phone
(765) 453-7710
NPI assigned
Apr 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Authorized official

Name
Dr. John Ladd, DDS
Title
Owner
Phone
(765) 453-7710

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0106X 12012039A IN
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 12012039A IN Primary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 12012039A IN

Addresses

Primary practice location

3415 S Lafountain St
Suite H
Kokomo, IN 46902-3802

Mailing address

3415 S Lafountain St
Suite H
Kokomo, IN 46902-3802
Phone (765) 453-7710

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396915200000",
    "number": "1992124879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 S LAFOUNTAIN ST",
            "address_2": "SUITE H",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023802",
            "telephone_number": "765-453-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 S LAFOUNTAIN ST",
            "address_2": "SUITE H",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023802",
            "telephone_number": "765-453-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY CENTER OF KOKOMO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-08",
        "last_updated": "2014-04-08",
        "status": "A",
        "authorized_official_last_name": "LADD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-453-7710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "IN",
            "license": "12012039A",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12012039A",
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12012039A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.