DR. GARY M BROUSELL (NPI# 1356311302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356311302 |
| Entity Type | Individual |
| Full Name | DR. GARY M BROUSELL |
| Credential | D.D.S. |
| Practice Address |
21 Gilbert Street Tinton Falls NJ 07724 |
| Mailing Address |
31 Wardell Cir Oceanport NJ 07757-1610 |
| Practice Telephone | 7327470993 |
| Practice Fax Number | 7327470961 |
| Mailing Telephone | 7327470993 |
| Mailing Fax Number | 7327470961 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2012-06-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
10690 | NJ | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 22DI0106000 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 1863401 | 05 |
| Street Address |
21 GILBERT STREET |
| City | TINTON FALLS |
| State | NJ |
| Zip Code | 07724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719788 | Zsanae Lewis | Driver | 1 Main St Unit 401, Eatontown, NJ 07724 | 2019-06-18 |
| 1417419169 | Refocus | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 613 Hope Road, Building 5 and 2, Eatontown, NJ 07724 | 2019-04-02 |
| 1215401575 | Angela Fordham-lewis | Day Training/Habilitation Specialist | 613 Hope Road, Building #2, Eatontown, NJ 07724 | 2019-01-18 |
| 1174094312 | Patti Kousoulis | Counselor | 10 Industrial Way East, Eatontown, NJ 07724 | 2018-12-16 |
| 1649745589 | Jersey Shore Dental Spa LLC | Dentist | 613 Hope Road Building 5, Eatontown, NJ 07724 | 2018-10-08 |
| 1487135448 | A2z Diagnostics LLC | Pathology | 6 Industrial Way W Ste F19, Eatontown, NJ 07724 | 2018-08-27 |
| 1942708268 | Elyce Jackson | Counselor | 10 Industrial Way, Eatontown, NJ 07724 | 2018-02-01 |
| 1477065894 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 249, Eatontown, NJ 07724 | 2017-10-25 |
| 1639681059 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 277, Eatontown, NJ 07724 | 2017-10-25 |
| 1669998100 | Seacrest Recovery Center North Jersey, LLC | Psychologist | 162 Highway 35, Eatontown, NJ 07724 | 2017-08-16 |
| Find all providers in zip 07724 | ||||
| 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 |
|---|---|---|---|---|
| 1659923969 | Sunhee Lee Dmd Pa | Oral & Maxillofacial Surgery | 1 Dewolf Rd Ste 102, Old Tappan, NJ 07675-7084 | 2019-07-16 |
| 1336630599 | Steven Frank Bogart Dds and Hubert Gugala Dmd | Oral & Maxillofacial Surgery | 57 Route 46 Suite 207, Hackettstown, NJ 07860 | 2018-05-23 |
| 1760910046 | Southern Ocean Osic, Inc | Oral & Maxillofacial Surgery | 1322 Route 72 W Ste 204, Manahawkin, NJ 08050-2486 | 2017-05-31 |
| 1245697432 | Middletown Oral Surgery Associates, P.C. | Oral & Maxillofacial Surgery | 21 New Monmouth Road, Middletown, NJ 07748 | 2016-01-20 |
| 1992118087 | Lanoka Shores LLC | Oral & Maxillofacial Surgery | 249 S Main St Unit 4, Barnegat, NJ 08005-2301 | 2014-06-05 |
| 1316382641 | Nikolay Levintov | Oral & Maxillofacial Surgery | C3 Cornwall Dr, East Brunswick, NJ 08816 | 2013-04-30 |
| 1912248683 | Mark Park | Oral & Maxillofacial Surgery | 260 Old Hook Rd Ste 202, Westwood, NJ 07675-3123 | 2013-03-06 |
| 1457417495 | Oral & Maxillofacial Assoc of Nutley | Oral & Maxillofacial Surgery | 187 Washington Avenue, Suite 1b, Nutley, NJ 07110 | 2006-12-27 |
| 1336216795 | Joseph D Dmaio | Oral & Maxillofacial Surgery | 590 Westfield Ave, Westfield, NJ 07090 | 2006-11-29 |
| 1508930678 | David Z Evdokimow | Oral & Maxillofacial Surgery | 96 S Finley Ave, Basking Ridge, NJ 07920-1422 | 2006-11-20 |
| Find all providers with the same taxonomy | ||||
| City | TINTON FALLS |
| Zip Code | 07724 |
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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.