SOUTHERN DE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PA (NPI# 1629144589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629144589 |
| Entity Type | Organization |
| Organization Name | SOUTHERN DE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PA |
| Practice Address |
1001 S Bradford St Suite 2 Dover DE 19904-4153 |
| Practice Telephone | 3026744450 |
| Practice Fax Number | 3026783228 |
| Mailing Telephone | 3026744450 |
| Mailing Fax Number | 3026783228 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BRUCE D FISHER (MANAGING PARTNER) |
| Authorized Official Telephone | 3026744450 |
| Authorized Official Credential | M.D., D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2000106563 | DE | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DE | 1000015026 | 05 |
| Street Address |
1001 S BRADFORD ST SUITE 2 |
| City | DOVER |
| State | DE |
| Zip Code | 19904-4153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548215981 | Vineet Puri | Internal Medicine | 1001 S Bradford St, Ste 9, Dover, DE 19904-4153 | 2006-05-24 |
| 1497381305 | Shabnam Mcquerrey | Nurse Practitioner | 1001 S Bradford St, Dover, DE 19904-4153 | 2020-03-23 |
| 1043755176 | Central Delaware Family Medicine | Family Medicine | 1001 S Bradford St, Ste. 4, Dover, DE 19904-4153 | 2016-12-28 |
| 1548635667 | Alexa Busler | Speech-Language Pathologist | 1001 S Bradford St, Suite 9, Dover, DE 19904-4153 | 2015-12-01 |
| 1780092528 | Anew Mental Health | Counselor | 1001 S Bradford St, Dover, DE 19904-4153 | 2014-07-24 |
| 1982960571 | Charlene T Trasser | Social Worker | 1001 S Bradford St, Suite 7, Dover, DE 19904-4153 | 2012-04-09 |
| 1194023770 | Time & Patience Consulting, LLC | Clinic/Center | 1001 S Bradford St, Suite # 10, Dover, DE 19904-4153 | 2011-03-07 |
| 1467666529 | Bonnie Lee Barber | Psychologist | 1001 S Bradford St, Suite #8, Dover, DE 19904-4153 | 2007-05-09 |
| 1275663569 | Beverly Jo King | Social Worker | 1001 S Bradford St, Ste #8, Dover, DE 19904-4153 | 2007-03-06 |
| 1679610695 | Bruce Donald Fisher | Dentist | 1001 S Bradford St, Suite 2, Dover, DE 19904-4153 | 2007-01-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534318 | Stanford Community Development Corporation, Inc | Community Health Worker | 111 South West Street, Suite 5, Dover, DE 19904 | 2020-10-02 |
| 1770145120 | Cara May O'reilly | Nurse Practitioner | 540 S. Governors Ave, Ste 101a, Dover, DE 19904 | 2019-07-07 |
| 1639631716 | Victoria Louise Sisson | Physical Therapy Assistant | 301 South Banning Street, Dover, DE 19904 | 2019-04-05 |
| 1336603091 | Ashley Santana | Counselor | 32 West Lookerman Street, Suite #103, Dover, DE 19904 | 2019-01-28 |
| 1679059869 | Vicdania Home Services | Technician | 1019 South Govenors Avenue, Dover, DE 19904 | 2018-07-11 |
| 1295221372 | Pam Squared At Dover LLC | Rehabilitation Hospital | 1240 Mckee Road, Dover, DE 19904 | 2018-07-02 |
| 1871000869 | Ronald Allen Beard | Counselor | 44 Carver Road, Dover, DE 19904 | 2017-12-29 |
| 1508376518 | First State Orthopaedics, Pa | Orthopaedic Surgery | 285 Beiser Blvd, Ste 201, Dover, DE 19904 | 2017-10-04 |
| 1700325057 | Center At Eden Hill LLC | Skilled Nursing Facility | 300 Banning Street, Dover, DE 19904 | 2017-02-20 |
| 1811352826 | West Dover Dental, LLC | Dentist | 2 Greentree Drive, Dover, DE 19904 | 2015-12-17 |
| Find all providers in zip 19904 | ||||
| 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 |
|---|---|---|---|---|
| 1982906467 | White Birch Oral Surgery, Pllc | Dentist | 44 Dover Point Rd Unit C, Dover, NH 03820-4669 | 2010-12-03 |
| 1033257530 | Douglas Lynn Ditty | Dentist | 1004 S State St Ste 1, Dover, DE 19901-6901 | 2007-02-05 |
| 1437250008 | Norman M Lippman | Dentist | 712 S Governors Ave, Dover, DE 19904 | 2006-09-26 |
| 1619321825 | Christopher King Dmd Pllc | Dentist | 801 Central Ave, Suite 1, Dover, NH 03820-2529 | 2016-04-14 |
| 1831458207 | Nicholas Alcorn | Dentist | 1004 S State St Ste 1, Dover, DE 19901-6925 | 2012-05-04 |
| 1679868095 | Rhae Anna L Riegel | Dentist | 1004 S State St Ste 1, Dover, DE 19901-6925 | 2011-06-14 |
| 1619102811 | Dover Oral and Maxillofacial Surgery | Dentist | 712 S Governors Ave, Dover, DE 19904-4106 | 2009-05-18 |
| 1790949261 | Christopher Allan King | Dentist | 801 Central Ave, Suite 1, Dover, NH 03820-2529 | 2008-07-15 |
| 1922127232 | First State Oral and Maxillofacial Surgery Corp | Dentist | 1004 S State St Ste 1, Dover, DE 19901-6901 | 2007-03-28 |
| 1679610695 | Bruce Donald Fisher | Dentist | 1001 S Bradford St, Suite 2, Dover, DE 19904-4153 | 2007-01-31 |
| Find all providers in DOVER | ||||
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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.