NPIMap

Organization Active NPI

Great River Oral and Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Dubuque, IA
National Provider Identifier
1992799811
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY PC
Practice address
100 Bryant St
Dubuque, IA 52003-7405
Phone
(563) 557-1440
Fax
(563) 557-7001
NPI assigned
Sep 7, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Thomas P Williams, DDSNPI 1780678466
Title
President
Phone
(563) 557-1440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X NU Primary

Addresses

Primary practice location

100 Bryant St
Dubuque, IA 52003-7405

Mailing address

100 Bryant St
Dubuque, IA 52003-7405
Phone (563) 557-1440

National Provider Directory

National Provider Directory

Locations

511 S 4th St
Clinton, IA 52732
Phone (563) 259-4349

100 Bryant St
Dubuque, IA 52003
Phone (563) 557-1440

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992799811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BRYANT ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037405",
            "telephone_number": "563-557-1440",
            "fax_number": "563-557-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRYANT ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037405",
            "telephone_number": "563-557-1440",
            "fax_number": "563-557-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER ORAL AND MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-557-1440",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.