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LOWER COLUMBIA HEAD & NECK ASSOCIATES PC NPI 1215150313


NPI Information

NPI: 1215150313
Provider Name: LOWER COLUMBIA HEAD & NECK ASSOCIATES PC
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Organization
Address:
820 11TH AVE
LONGVIEW, WA
ZIP 98632
Phone: (360) 423-0960
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LOWER COLUMBIA HEAD & NECK ASSOCIATES PC is an oral maxillofacial surgery in Longview, WA. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. LOWER COLUMBIA HEAD & NECK ASSOCIATES PC NPI is 1215150313. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

820 11TH AVE
LONGVIEW, WA
ZIP 98632-072
Phone: (360) 423-0960
Fax: (360) 423-8902

The provider's authorized official is Alexander P Ierokomos .
The authorized official title is President and has the following contact phone number (360) 423-0960.

The enumeration date for this NPI number is 4/10/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1204E00000XOral & Maxillofacial SurgeryMD00022010WASHINGTONYes
2207Y00000XOtolaryngologyMD00022010WASHINGTONX
3207YP0228XOtolaryngologyPediatric OtolaryngologyMD00022010WASHINGTONX
4207YS0012XOtolaryngologySleep MedicineMD00022010WASHINGTONX
5207YX0007XOtolaryngologyPlastic Surgery within the Head & NeckMD00022010WASHINGTONX
6207YX0602XOtolaryngologyOtolaryngic AllergyMD00022010WASHINGTONX
7207YX0905XOtolaryngologyOtolaryngology/Facial Plastic SurgeryMD00022010WASHINGTONX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
160170OTHERWASHINGTONL&I
27032030MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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