ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, P.C. (NPI# 1497808588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497808588 |
Entity Type | Organization |
Organization Name | ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, P.C. |
Practice Address |
105 E 1st St Suite 103 Hinsdale IL 60521-4249 |
Practice Telephone | 6307898070 |
Practice Fax Number | 6308507537 |
Mailing Telephone | 6307898070 |
Mailing Fax Number | 6308507537 |
Enumeration Date | 2007-01-19 |
Last Update Date | 2020-08-22 |
Authorized Official Name | CAROL BONAMI (PRACTICE MANAGER) |
Authorized Official Telephone | 6307898070 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
Street Address |
105 E 1ST ST SUITE 103 |
City | HINSDALE |
State | IL |
Zip Code | 60521-4249 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619987922 | Richard John Balcerak | Dentist | 105 E 1st St, Ste 103, Hinsdale, IL 60521 | 2006-08-09 |
1750453825 | Michael A. Klepacki | Dentist | 105 E 1st St, Suite 201, Hinsdale, IL 60521-4249 | 2006-11-14 |
1598853673 | Nicole Rojas | Physical Therapist | 105 E 1st St, Hinsdale, IL 60521-4249 | 2006-10-11 |
1770671414 | Tyran Eric Johnson | Dentist | 105 E 1st St, Suite 103, Hinsdale, IL 60521-4249 | 2006-10-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386256170 | Infinity Yoga LLC | Counselor | 702 Mills St, Hinsdale, IL 60521 | 2020-08-21 |
1427696855 | Anne Didier | Nurse Practitioner | 40 South Clay St., Suite 200, West Building, Hinsdale, IL 60521 | 2019-12-16 |
1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
1639680275 | Kelly M Lyell | Psychologist | 950 S Oak St, Hinsdale, IL 60521 | 2017-10-23 |
1386169720 | Elizabeth Ann Thorsness | Counselor | 412 East Fourth St., Hinsdale, IL 60521 | 2017-08-07 |
1275057424 | Bryndal Nicole Chervinko | Audiologist | 908 North Elm Street, Suite 306, Hinsdale, IL 60521 | 2017-07-31 |
1972038990 | Carolyn M Ball | Counselor | 19 N Grant St Ste 2c, Hinsdale, IL 60521 | 2017-04-27 |
1710429964 | Smiling Star Speech & Language | Speech-Language Pathologist | 120 E Odgen Avenue, Suite 110, Hinsdale, IL 60521 | 2016-11-04 |
1972964773 | Sharon Grob Murphy | Psychologist | 728 S. Park Ave., Hinsdale, IL 60521 | 2016-03-08 |
1992187074 | Matthew Destefani | Emergency Medicine | 109 Symonds Dr # 578, Hinsdale, IL 60521 | 2015-06-24 |
Find all providers in zip 60521 |
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 |
---|---|---|---|---|
1043607872 | Alissa Nicole Pullos | Dentist | 105 E 1st St Ste 103, Hinsdale, IL 60521 | 2015-04-20 |
1609983394 | Robert David Schwartz | Dentist | 105 E First Street, Suite 103, Hinsdale, IL 60521 | 2006-08-25 |
1619987922 | Richard John Balcerak | Dentist | 105 E 1st St, Ste 103, Hinsdale, IL 60521 | 2006-08-09 |
1770671414 | Tyran Eric Johnson | Dentist | 105 E 1st St, Suite 103, Hinsdale, IL 60521-4249 | 2006-10-10 |
1518074202 | Jeffrey K Collins | Dentist | 105 E First Street, Suite 103, Hinsdale, IL 60521 | 2006-08-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
1215410584 | David Peterson | Dentist | 1619 Brandywine Ln, Dixon, IL 61021-8757 | 2018-09-12 |
1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
1093232951 | Robert C. Bosack, Dds & Associates, Ltd | Dentist | 16011 108th Ave Ste A, Orland Park, IL 60467-8787 | 2017-08-23 |
1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
1770962375 | Eunsu Jung | Dentist | 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 | 2015-05-28 |
1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
1538592654 | Matthew Seena Hamedani | Dentist | 3116 Oak Park Ave, Berwyn, IL 60402 | 2013-08-13 |
1578907689 | M Timothy Murphy | Dentist | 500 Davis St Ste 509, Evanston, IL 60201-4621 | 2013-04-18 |
1104260314 | Cameron James Walker | Dentist | 2160 S 1st Ave Rm 1814, Maywood, IL 60153-3328 | 2013-04-18 |
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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.