SOUTHWEST ORAL AND MAXILLOFACIAL SURGERY,LLC (NPI# 1023347937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023347937 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST ORAL AND MAXILLOFACIAL SURGERY,LLC |
| Practice Address |
620 Pointe North Boulevard Albany GA 31721 |
| Mailing Address |
Po Box 4896 Canton GA 30114-0026 |
| Practice Telephone | 6783506566 |
| Mailing Telephone | 6783506566 |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2009-12-24 |
| Authorized Official Name | DR. BRAD J HARRIS (SOLE MEMBER/ORAL SURGEON) |
| Authorized Official Telephone | 6783506566 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DNO12915 | GA | Dental Providers |
| Street Address |
620 POINTE NORTH BOULEVARD |
| City | ALBANY |
| State | GA |
| Zip Code | 31721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801354139 | Quintavius Martin | Physical Therapy Assistant | 2933 Stonewater Drive, Albany, GA 31721 | 2019-03-05 |
| 1851809180 | Dialysis Clinic Inc | Clinic/Center | 650 Pointe North Blvd, Albany, GA 31721 | 2018-01-22 |
| 1336668961 | Muntaisha Shunquill Ross | Contractor | 3718 Mayfair Lane, Apt B, Albany, GA 31721 | 2017-09-14 |
| 1861942252 | Winifred Davis | Contractor | 407 Wiregrass Way, Albany, GA 31721 | 2016-10-10 |
| 1922203413 | John Ronald Andrews | Radiology | 2205 West Doublegate Drive, Albany, GA 31721 | 2007-06-15 |
| 1124147608 | Jeffrey R Singleton | Dentist | 602 Pointe North Blvd., Albany, GA 31721 | 2007-03-28 |
| 1508921883 | Thomas William Monahan IIi | Dentist | 609 Pointe North Blvd, Albany, GA 31721 | 2006-12-27 |
| 1437563475 | Michael James Cox | Dentist | 602 Pointe North Blvd, Albany, GA 31721-1513 | 2014-06-18 |
| 1366553901 | Tania Smith | Pediatrics | 600 Pointe North Blvd, Albany, GA 31721-1513 | 2006-08-31 |
| 1316459795 | Angela Anglin Stevens | Nurse Practitioner | 600 Pointe North Blvd, Albany, GA 31721-1513 | 2017-10-25 |
| Find all providers in zip 31721 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730737545 | Southwoods Boulevard Dental, P.C. | Dentist | 7 Southwoods Blvd Ste 1, Albany, NY 12211-2526 | 2019-08-27 |
| 1770741514 | Dr Stephen E Carney Dr Christopher H Reilly Dr Bret D Gelder | Dentist | 10 Airline Dr, Suite 204, Albany, NY 12205-1025 | 2008-05-29 |
| 1891902896 | Howerton, Hopkin & Kennedy LLC | Dentist | 1040 24th Ave Sw, Albany, OR 97321-7539 | 2007-05-17 |
| 1689763914 | Marvin L Allen Jr. | Dentist | 316 Fifth Avenue, Albany, GA 31701 | 2006-10-12 |
| 1962590604 | Frank Havelook White IIi | Dentist | 706 N Slappey Blvd, Albany, GA 31701 | 2006-10-10 |
| 1760573307 | Michael John Doucet | Dentist | 419 San Pablo Ave, Albany, CA 94706 | 2006-09-27 |
| 1992269799 | A Khalil Dds Apc | Dentist | 419 San Pablo Ave, Albany, CA 94706-1124 | 2019-01-25 |
| 1508229402 | Mohamed Bayoumy | Dentist | 2 Executive Park Dr, Albany, NY 12203-3700 | 2016-03-30 |
| 1508121534 | Timothy M Adams | Dentist | 7 Southwoods Blvd, Albany, NY 12211-2514 | 2012-07-05 |
| 1316217540 | Alexis Lee Kleinman | Dentist | 2 Executive Park Dr, Albany Oms Group, Albany, NY 12203-3700 | 2012-01-04 |
| Find all providers in ALBANY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.