Midland Oral Surgery and Implant Centers, LTD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MIDLAND ORAL SURGERY AND IMPLANT CENTERS, LTD

Practice address

800 Hillgrove Ave Ste 201
Western Springs, IL 60558-1470

Phone

(708) 678-1011

NPI assigned

Jul 2, 2024

Organization subpart

No

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

Authorized official

Name

Aaron Tucke, DDS

Title

Ceo

Phone

(215) 828-9559

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Kasper,Heaton,Wright,Pagni,Andassociates,LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Homer Glen, IL
  • NPI 1639187834

  O20050923000379

  Same enrollment
• Kasper,Heaton,Wright,Pagni,Andassociates,LTD.

  • Oral and Maxillofacial Surgery (Dentist)
  • Darien, IL
  • NPI 1861400061

  O20050923000379

  Same enrollment
• Midland Oral Surgery and Implant Centers, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Frankfort, IL
  • NPI 1396995783

  O20050923000379

  Same enrollment
• Midland Oral Surgery and Implant Centers, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Lawn, IL
  • NPI 1669480851

  O20050923000379

  Same enrollment
• Midland Oral Surgery and Implant Centers, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Tinley Park, IL
  • NPI 1801804182

  O20050923000379

  Same enrollment

Locations

Practitioners 4

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

• Wilson P Heaton, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Lawn, IL
  • NPI 1134137474

  Oral and Maxillofacial Surgery

  NPD (past)
• Edward L Kasper, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Lawn, IL
  • NPI 1841208147

  Oral and Maxillofacial Surgery

  NPD (past)
• Robert Thomas Gramins, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Poway, CA
  • NPI 1285711291

  Oral and Maxillofacial Surgery

  NPD (past)
• Bradley C Wright, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Hutchinson, KS
  • NPI 1043228398

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1992541635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674620",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674620",
            "telephone_number": "708-423-5990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 HILLGROVE AVE STE 201",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581470",
            "telephone_number": "708-678-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND ORAL SURGERY AND IMPLANT CENTERS, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "TUCKE",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-828-9559",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deeana Marie McGlynn
• Megan Hanson Speech Therapy PLLC
• Colin J Meister, DPT
• Melvin Glick MD
• Ashley L Michelsen, PA-C
• Izabela Milenkovska, PHARMD
• Erin Michelle Miller, BCBA
• Marjorie Miller, DDS
• Jessica Milos
• Marianne Elizabeth Minas, BSW

• All providers in Western Springs, IL
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.