EASTERN OKLAHOMA ORAL MAXILLOFACIAL SURGEONS (NPI# 1629151188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629151188 |
| Entity Type | Organization |
| Organization Name | EASTERN OKLAHOMA ORAL MAXILLOFACIAL SURGEONS |
| Practice Address |
2950 S Elm Place, Suite 340 Broken Arrow OK 74012 |
| Mailing Address |
4716 W Urbana St Broken Arrow OK 74012-5997 |
| Practice Telephone | 9184510944 |
| Mailing Telephone | 9184495800 |
| Mailing Fax Number | 9184558958 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | MR. VIC HILL TRAMMELL (OWNER / SURGEON) |
| Authorized Official Telephone | 9184510944 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
2950 S ELM PLACE, SUITE 340 |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| 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 |
|---|---|---|---|---|
| 1124133061 | Lester Lyman Cowden IIi | Oral & Maxillofacial Surgery | 3100 W Britton Rd, Suite A, Oklahoma City, OK 73120-2036 | 2006-08-20 |
| 1124050208 | Alan Akio Miyake | Oral & Maxillofacial Surgery | 1201 N. Stonewall Ave Dcsb 206, Oklahoma City, OK 73117-1214 | 2006-07-07 |
| 1598931735 | Beomjune B Kim | Oral & Maxillofacial Surgery | 10109 E. 79th Street, Tulsa, OK 74133 | 2008-05-07 |
| 1821131731 | Shawne Higashi | Oral & Maxillofacial Surgery | 1201 N Stonewall Ave, Room 206, Oklahoma City, OK 73117-1214 | 2007-02-14 |
| 1518000421 | Shawn B Davis | Oral & Maxillofacial Surgery | 1201 N Stonewall Ave, Room 206, Oklahoma City, OK 73117-1214 | 2007-02-14 |
| City | BROKEN ARROW |
| Zip Code | 74012 |
Please comment or provide details below to improve the information on EASTERN OKLAHOMA ORAL MAXILLOFACIAL SURGEONS.
| 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.