UNIVERSITY OF PENN - ORAL SURGERY ASSOCIATES (NPI# 1912011321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912011321 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF PENN - ORAL SURGERY ASSOCIATES |
| Practice Address |
3400 Spruce St 5 White Building Philadelphia PA 19104-4206 |
| Mailing Address |
3624 Market St Suite 560w Philadelphia PA 19104-2614 |
| Practice Telephone | 2156623580 |
| Practice Fax Number | 2156627445 |
| Mailing Telephone | 2156622286 |
| Mailing Fax Number | 2156150500 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2014-01-06 |
| Authorized Official Name | ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2156627583 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | HEALTHPARTNERS | 07658 | 01 |
| PA | AETNA | 119663 | 01 |
| NJ | NJ MEDICAID | 7417705 | 01 |
| PA | HEALTHNET | 2Y20463 | 01 |
| PA | KEYSTONE | 0060894000 | 01 |
| PA | BLUE SHIELD | 181611 | 01 |
| PA | KEYSTONE MERCY | 1008672 | 01 |
| PA | RR MEDICARE | CA2596 | 01 |
| PA | 0019334710 | 05 |
| Street Address |
3400 SPRUCE ST 5 WHITE BUILDING |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063415966 | Samuel Isaiah Parry | Obstetrics & Gynecology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2005-05-24 |
| 1831790609 | Renate Marie Balitzky | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-11-06 |
| 1053911156 | Jordan Charles Templeton | Physician Assistant | 3400 Spruce St, Philadelphia, PA 19104-4274 | 2020-10-28 |
| 1992305304 | Alyssa N Volpe | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-27 |
| 1700486115 | Christina Haddow | Registered Nurse | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-27 |
| 1629677497 | Marissa Leigh Berlant | Physician Assistant | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-22 |
| 1811595523 | Kristen Gilgen | Anesthesiology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-10-14 |
| 1962014654 | Stacey Pham | Nurse Practitioner | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-08-23 |
| 1265040109 | Abdullah T Almuqate | Pathology | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-07-16 |
| 1952928541 | Stefen Andrianus | Student in an Organized Health Care Education/Training Program | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2020-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| 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 |
|---|---|---|---|---|
| 1376990853 | Center City Oral & Maxillofacial Surgery | Oral & Maxillofacial Surgery | 1740 South St Ste 302, Philadelphia, PA 19146-1572 | 2016-05-16 |
| 1730268079 | Children's Surgical Associates Ltd | Oral & Maxillofacial Surgery | 34th & Civc Center Blvd, Children's Hospital of Philadelphia, Philadelphia, PA 19104 | 2006-11-06 |
| 1598724288 | Gerard T. Dowd | Oral & Maxillofacial Surgery | 9525 Frankford Ave, Philadelphia, PA 19114-2812 | 2006-03-21 |
| 1245885060 | Sean Jia Hoong Lim | Oral & Maxillofacial Surgery | 909 Walnut St Fl 3, Philadelphia, PA 19107-5211 | 2019-08-08 |
| 1457706608 | Katherine Alden Doan France | Oral & Maxillofacial Surgery | 3400 Civic Center Blvd, South Pavilion, 4th Floor, Philadelphia, PA 19104-5127 | 2016-04-25 |
| 1942573902 | Maxillofacial Surgical Associates, P.C. | Oral & Maxillofacial Surgery | 1601 Walnut St, Suite 1116, Philadelphia, PA 19102-2944 | 2012-02-21 |
| 1811202633 | Rabie M Shanti | Oral & Maxillofacial Surgery | 3400 Civic Center Blvd, South Pavilion, 3rd Floor, Philadelphia, PA 19104-5127 | 2010-08-17 |
| 1649506577 | Takako Tanaka | Oral & Maxillofacial Surgery | 3400 Civic Center Blvd, 4th Floor, South Pavilion, Philadelphia, PA 19104-5127 | 2009-10-28 |
| 1922237981 | Neeraj H. Panchal | Oral & Maxillofacial Surgery | 3400 Civic Center Blvd., 4th Floor, South Pavilion, Philadelphia, PA 19104 | 2009-07-10 |
| 1023244654 | Steven W Wang | Oral & Maxillofacial Surgery | 3400 Spruce St, One Maloney, Philadelphia, PA 19104-4206 | 2009-06-10 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
Please comment or provide details below to improve the information on UNIVERSITY OF PENN - ORAL SURGERY ASSOCIATES.
| 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.