BUCKEYE ORAL & MAXILLOFACIAL SURGEY


Address: 110 Polaris Parkway, Suite 110, Westerville, OH 43082-0000
Phone: 6147949700

BUCKEYE ORAL & MAXILLOFACIAL SURGEY (NPI# 1073855193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073855193
Entity Type Organization
Organization Name BUCKEYE ORAL & MAXILLOFACIAL SURGEY
Other Organization Name BUCKEYE ORAL & MAXILLOFACIAL SURGERY
Practice Address 110 Polaris Parkway
Suite 110
Westerville
OH 43082-0000
Mailing Address Po Box 2443
Westerville
OH 43086-2443
Practice Telephone 6147949700
Mailing Telephone 6147949700
Enumeration Date 2013-03-27
Last Update Date 2013-03-27
Authorized Official Name DR. JACK B MCEWAN (OWNER)
Authorized Official Telephone 6147949700
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QS0112X Clinic/Center
Specialization: Oral and Maxillofacial Surgery
30022456 OH Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
OH 2711882 05

Other Provider/Organization Names

Other Name Type Code
Buckeye Oral & Maxillofacial Surgery Former Legal Business Name - Organization

Office Location

Street Address 110 POLARIS PARKWAY
SUITE 110
City WESTERVILLE
State OH
Zip Code 43082-0000

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023501509 Taylor Wucinich Audiologist 387 County Line Rd W Ste 116, Westerville, OH 43082 2018-06-11
1366940132 Hogan Nicklaus Marshall Specialist/Technologist 7118 Mount Royal Ave, Westerville, OH 43082 2018-01-26
1356858450 Margaret Adams Chiropractor 387 County Line Rd. W, 215, Westerville, OH 43082 2018-01-10
1326407701 Heidi A. Stauffer Dds Dentist 124 County Line Rd W, Suite A, Westerville, OH 43082 2016-02-15
1629324553 Mavis Asamoah Licensed Practical Nurse 5401 Country Meadow Ct, Westerville, OH 43082 2012-07-30
1326283698 Amy Lyn Gosnell Dermatology 300 Polaris Pkwy Ste 3300, Westerville, OH 43082 2008-12-15
1215186705 Molly Hauer Nursing Facility/Intermediate Care Facility 7017 Laver Ln, Westerville, OH 43082 2008-09-09
1013181205 Tridia Hospice Care, Inc. Hospice Care, Community Based 110 Polaris Pkwy Ste 302, Westerville, OH 43082 2008-04-17
1174702070 Kathryn J Watkins Younkin Dentist 450 Alkyre Run Dr, Suite 290, Westerville, OH 43082 2007-10-26
1033300900 Audrey Jones Student in an Organized Health Care Education/Training Program 187 W. Schrock Rd, Children's Hospital Guidance Center, Westerville, OH 43082 2007-08-06
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Taxonomy Information

Taxonomy Code 261QS0112X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1083907539 Brian C. Weaver, Dds, LLC Clinic/Center 627 Office Pkwy, Suite B, Westerville, OH 43082-7988 2011-05-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1588131528 James A Maxwell Jr Dds, Inc Clinic/Center 2210 Olympic St, Springfield, OH 45503-2737 2018-10-29
1013450014 Muskingum Valley Oral Surgery, Inc. Clinic/Center 7297 John Glenn Hwy, Cambridge, OH 43725-9034 2016-11-22
1164854774 Comprehensive Oral & Maxillofacial Surgery Center Clinic/Center 5319 Meadow Lane Ct, Sheffield Village, OH 44035-1469 2013-08-06
1508209446 Nationwide Children's Clinic/Center 700 Childrens Dr, Columbus, OH 43205-2664 2013-04-10
1760723902 Case School of Dental Medicine Clinic/Center 2124 Cornell Rd, Cleveland, OH 44106-3804 2013-03-13
1356667323 Dennis G Pettit Dds Inc Clinic/Center 1762 Commerce Center Blvd, Fairborn, OH 45324-6358 2010-04-15
1427383272 Western Reserve Center for Orofacial and Cosmetic Surgery Clinic/Center 14700 Detroit Ave, Lakewood, OH 44107-4116 2009-10-13
1700027042 Kenneth J Molnar Dds Inc Clinic/Center 2191 Park Ave W, Mansfield, OH 44906-1226 2009-03-17
1861663106 Center for Oral and Maxillofacial Surgery Clinic/Center 28871 Center Ridge Rd, Suite 104, Westlake, OH 44145-5271 2008-03-14
1821293648 Richard J. Lee Dds Inc Clinic/Center 801 Sandusky St, Fostoria, OH 44830-2747 2007-06-20
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Competitor

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City WESTERVILLE
Zip Code 43082

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Dataset Information

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.

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