ORAL SURGERY OF WEST AUGUSTA PC


Address: 3634 Wheeler Rd, Augusta, GA 30909-6518
Phone: 7068608228

ORAL SURGERY OF WEST AUGUSTA PC (NPI# 1538571435) 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) 1538571435
Entity Type Organization
Organization Name ORAL SURGERY OF WEST AUGUSTA PC
Practice Address 3634 Wheeler Rd
Augusta
GA 30909-6518
Practice Telephone 7068608228
Practice Fax Number 7068607222
Mailing Telephone 7068608228
Mailing Fax Number 7068607222
Enumeration Date 2014-05-27
Last Update Date 2014-05-27
Authorized Official Name DR. BORIS J SIDOW (OWNER SURGEON)
Authorized Official Telephone 7068608228
Authorized Official Credential D.D.S.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 204E00000X Oral & Maxillofacial Surgery DN013478 GA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TRICARE ACTIVE DUTY DENTAL PLAN 000425742 01
GA 000056438C 05
GA 000056427C 05
TRICARE ACTIVE DUTY DENTAL PLAN 002068046 01
GA 111331508B 05
TRICARE ACTIVE DUTY DENTAL PLAN 000848645 01

Office Location

Street Address 3634 WHEELER RD
City AUGUSTA
State GA
Zip Code 30909-6518

Providers in the same location

NPI Name Taxonomy Address Enumeration
1548205636 Drs. Peacock & Rafoth, P.C. Dentist 3634 Wheeler Rd, Augusta, GA 30909-6518 2006-06-20
1659567121 Robert F Rafoth Dentist 3634 Wheeler Rd, Augusta, GA 30909-6518 2007-09-19
1205022779 Ronald Thomas Peacock Dentist 3634 Wheeler Rd, Augusta, GA 30909-6518 2007-09-19

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1912513888 Lauran Simpson Behavior Technician 1237 Augusta West Parkway, Augusta, GA 30909 2020-09-16
1487273884 Still Perspectives Counseling LLC Counselor 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 2020-04-15
1598397838 Mjra Medical LLC Psychologist 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 2020-02-05
1003452319 Danny Robinson Counselor 2609 Commons Boulevard, Augusta, GA 30909 2019-11-21
1407498637 Candice M Cruse Social Worker 2609 Commons Blvd, Augusta, GA 30909 2019-10-09
1902363385 Mary D Jodon Pharmacist 3338 Wrightsboro Rd., Augusta, GA 30909 2019-02-21
1447790514 Burn Critical Care Associates, LLC Internal Medicine 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 2017-03-08
1124561766 Sasha Latara Mccraw Counselor 7303 Palomino Court, Augusta, GA 30909 2016-11-30
1174974620 Warren Umansky, Ph.d. Psychologist 302 Wheeler Executive Ctr, Augusta, GA 30909 2016-06-27
1811358955 Theodora Mcleskey Nurse Practitioner 1215 George C. Wilson Drive, Augusta, GA 30909 2016-03-17
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Taxonomy Information

Taxonomy Code 204E00000X
Grouping Allopathic & Osteopathic Physicians
Classification Oral & Maxillofacial Surgery

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184667370 Scott S Derossi Oral & Maxillofacial Surgery 1430 John Wesley Gilbert Drive, Gc-1024, Ghsu College of Dental Medicine, Augusta, GA 30912-1001 2006-06-14
1942258397 Henry W Ferguson Oral & Maxillofacial Surgery 1430 John Wesely Gilbert Drive, Gc-1024, Augusta, GA 30912-1001 2006-05-05
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

Providers in the same taxonomy and state

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
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Competitor

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City AUGUSTA
Zip Code 30909

Improve Information

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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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