SCOTT S DEROSSI (NPI# 1184667370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184667370 |
| Entity Type | Individual |
| Full Name | SCOTT S DEROSSI |
| Credential | DMD |
| Practice Address |
1430 John Wesley Gilbert Drive, Gc-1024 Ghsu College of Dental Medicine Augusta GA 30912-1001 |
| Practice Telephone | 7067219633 |
| Practice Fax Number | 7067230266 |
| Mailing Telephone | 7067219633 |
| Mailing Fax Number | 7067230266 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2012-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | DS029512L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0016969200001 | 05 |
| Street Address |
1430 JOHN WESLEY GILBERT DRIVE, GC-1024 GHSU COLLEGE OF DENTAL MEDICINE |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| 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. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942258397 | Henry W Ferguson | Oral & Maxillofacial Surgery | 1430 John Wesely Gilbert Drive, Gc-1024, Augusta, GA 30912-1001 | 2006-05-05 |
| 1538571435 | Oral Surgery of West Augusta PC | Oral & Maxillofacial Surgery | 3634 Wheeler Rd, Augusta, GA 30909-6518 | 2014-05-27 |
| 1225202484 | Jeffrey Nelson James | Oral & Maxillofacial Surgery | 1120 15th St, Augusta, GA 30912-5536 | 2008-04-18 |
| 1407878606 | Mark R Stevens | Oral & Maxillofacial Surgery | 1120 15th St, Augusta, GA 30912-0004 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124453337 | Ladi Doonquah | Oral & Maxillofacial Surgery | 3660 Flat Shoals Rd Ste 100, Decatur, GA 30034-1649 | 2013-09-06 |
| 1699040121 | Shenan Marie Bradshaw | Oral & Maxillofacial Surgery | 5505 Peachtree Dunwoody Rd Ste 660, Sandy Springs, GA 30342 | 2012-03-16 |
| 1720107105 | Christian Loetscher | Oral & Maxillofacial Surgery | 4205 N Point Pkwy Ste F, Alpharetta, GA 30022-8808 | 2007-03-28 |
| 1659460772 | William Jones Phillips | Oral & Maxillofacial Surgery | 698 Medical Park Lane, Gainesville, GA 30501 | 2006-10-12 |
| 1841306909 | Lawrence Matthew Marra | Oral & Maxillofacial Surgery | 3965 Holcomb Bridge Road, Suite 102, Norcross, GA 30092 | 2006-08-22 |
| 1861505141 | Durwood M Johnson Jr. | Oral & Maxillofacial Surgery | 1260 Hwy 54 W, Suite 200, Fayetteville, GA 30214 | 2006-08-17 |
| 1295791549 | Glenn Maron | Oral & Maxillofacial Surgery | 999 Peachtree St Ne, Ste 715, Atlanta, GA 30309 | 2006-04-25 |
| 1952363442 | Advanced Oral and Maxillofacial Surgery PC | Oral & Maxillofacial Surgery | 3535 Roswell Rd, Suite 27, Marietta, GA 30062-8826 | 2006-04-03 |
| 1114425964 | Gofs Stockbridge | Oral & Maxillofacial Surgery | 225 Country Club Dr, #110, Stockbridge, GA 30281 | 2018-01-26 |
| 1811403207 | Premier Anesthesia of Georgia LLC | Oral & Maxillofacial Surgery | 11 Upper Riverdale Rd, Riverdale, GA 30274 | 2017-12-20 |
| Find all providers with the same taxonomy | ||||
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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.