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GASTON ORAL & MAXILLOFACIAL SURGERY NPI 1538279757


NPI Information

NPI: 1538279757
Provider Name: GASTON ORAL & MAXILLOFACIAL SURGERY

Doing Business As: GASTON ORAL & MAXILLOFACIAL SURGERY

Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Organization
Address:
GASTON ORAL & MAXILLOFACIAL SURGERY
571 COX ROAD
GASTONIA, NC
ZIP 28054
Phone: (704) 865-7603
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GASTON ORAL & MAXILLOFACIAL SURGERY is an oral maxillofacial surgery in Gastonia, NC. 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. GASTON ORAL & MAXILLOFACIAL SURGERY NPI is 1538279757. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Gaston Oral & Maxillofacial Surgery.

The provider's business location address is:

GASTON ORAL & MAXILLOFACIAL SURGERY
571 COX ROAD
GASTONIA, NC
ZIP 28054-632
Phone: (704) 865-7603
Fax: (704) 865-6411

The provider's authorized official is Philip Ledford Jamison .
The authorized official title is Direct Owner and has the following contact phone number (704) 865-7603.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 2/13/2019.


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
11223S0112XDentistOral and Maxillofacial SurgeryNo
2204E00000XOral & Maxillofacial SurgeryYes

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
18994489MEDICAIDNORTH CAROLINA
290868OTHERNORTH CAROLINABCBS PROVIDER NUMBER
38990868MEDICAIDNORTH CAROLINA
494489OTHERNORTH CAROLINABCBS PROVIDER NUMBER

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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