NPIMap

Organization Active NPI

South Shore Oral Surgery Assoc PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Rockville Centre, NY
National Provider Identifier
1992889695
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
SOUTH SHORE ORAL SURGERY ASSOC PC
Practice address
24 Maple Ave
South Shore Oral Surgery Assoc PC Suite 6
Rockville Centre, NY 11570
Phone
(516) 766-0580
Fax
(516) 766-6755
NPI assigned
Oct 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Mrs. Donna A Vanness
Title
Office Manager
Phone
(516) 766-0580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

24 Maple Ave
South Shore Oral Surgery Assoc PC Suite 6
Rockville Centre, NY 11570

Mailing address

24 Maple Ave
South Shore Oral Surgery Assoc PC Suite 6
Rockville Centre, NY 11570
Phone (516) 766-0580

National Provider Directory

National Provider Directory

Locations

24 Maple Ave
Ste 6
Rockville Ctr, NY 11570
Phone (516) 766-0580

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1992889695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MAPLE AVE",
            "address_2": "SOUTH SHORE ORAL SURGERY ASSOC PC SUITE 6",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11570",
            "telephone_number": "516-766-0580",
            "fax_number": "516-766-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MAPLE AVE",
            "address_2": "SOUTH SHORE ORAL SURGERY ASSOC PC SUITE 6",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "11570",
            "telephone_number": "516-766-0580",
            "fax_number": "516-766-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE ORAL SURGERY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "VANNESS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "516-766-0580",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.