CHARLOTTESVILLE ORAL SURGERY AND DENTAL IMPLANT CENTER, LLC (NPI# 1972740454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972740454 |
| Entity Type | Organization |
| Organization Name | CHARLOTTESVILLE ORAL SURGERY AND DENTAL IMPLANT CENTER, LLC |
| Practice Address |
1415 Rolkin Ct Ste 101 Charlottesville VA 22911-3643 |
| Practice Telephone | 4342950911 |
| Mailing Telephone | 4342950911 |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2018-11-14 |
| Authorized Official Name | DR. CARLOS IBANEZ (PRESIDENT) |
| Authorized Official Telephone | 4348237711 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
0438000261 | VA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 2105438 | 05 |
| Street Address |
1415 ROLKIN CT STE 101 |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22911-3643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760840912 | Hearing At Home | Hearing Instrument Specialist | 103 Free Brige Ln, Charlottesville, VA 22911 | 2016-02-03 |
| 1649637752 | Ebony Cosby | Contractor | 2500 Boulders Rd, Charlottesville, VA 22911 | 2016-01-20 |
| 1629452727 | Ahmed M Murtuza | Pharmacist | 925 Dorchester Pl Apt. 103, Charlottesville, VA 22911 | 2015-07-17 |
| 1083093231 | Kimberly P Tran | Dentist | 1470 Pantops Mountain Pl Ste 1, Charlottesville, VA 22911 | 2015-05-20 |
| 1508252982 | Alexandra M Bender | Family Medicine | 3263 Proffit Rd Ste 201, Charlottesville, VA 22911 | 2015-04-13 |
| 1538599980 | Commonwealth Dental Anesthesiology Inc | Clinic/Center | 1460-b Pantops Mountain Place, Charlottesville, VA 22911 | 2013-11-21 |
| 1831386606 | Hudson Chiropractic P.C. | Chiropractor | 103-a Free Bridge Lane, Charlottesville, VA 22911 | 2007-09-26 |
| 1386863421 | Laura P Smith | Specialist | 595 Peter Jefferson Parkway Suite 390, Reproductive Medicine and Surgery Center of Va, Charlottesville, VA 22911 | 2007-04-25 |
| 1609928621 | Bl Enterprises, LLC | Physical Therapist | 1405 Rolkin Court, Suite 102, Charlottesville, VA 22911 | 2007-01-18 |
| 1972660959 | Kenneth I. Barron | Obstetrics & Gynecology | 630 Peter Jefferson Pkwy Ste 140b, Charlottesville, VA 22911 | 2007-01-02 |
| Find all providers in zip 22911 | ||||
| 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 |
|---|---|---|---|---|
| 1114903739 | Nathaniel D Tricker | Dentist | 244 Hydraulic Ridge Road, Central Virginia Oral & Facial Surgeons, Charlottesville, VA 22901 | 2005-12-15 |
| 1942296819 | Edward Sullivan Amrhein | Dentist | 244 Hydraulic Ridge Rd, Charlottesville, VA 22901-8124 | 2005-09-26 |
| 1154327005 | Carlos R Ibanez | Dentist | 1415 Rolkin Court, Suite 101, Charlottesville, VA 22911 | 2005-06-24 |
| 1083785091 | Gregory A Conner | Dentist | 244 Hydraulic Ridge Road, Charlottesville, VA 22901 | 2006-11-13 |
| 1316969736 | Peter W Eisenhardt | Dentist | 244 Hydraulic Ridge Rd, Charlottesville, VA 22901-8124 | 2006-07-24 |
| 1679595003 | W. Jackson Faircloth Jr. | Dentist | 244 Hydraulic Ridge Rd, Charlottesville, VA 22901-8124 | 2006-07-24 |
| 1972525319 | Miles L Wilhelm | Dentist | 244 Hydraulic Ridge Rd, Charlottesville, VA 22901-8124 | 2006-07-24 |
| 1154349991 | Tonu Thomas Kangur | Dentist | 244 Hydraulic Ridge Rd, Charlottesville, VA 22901-8124 | 2006-07-18 |
| 1336167006 | Central Virginia Oral & Facial Surgeons, Plc | Dentist | 244 Hydraulic Ridge Rd, Charlottesville, VA 22901-8124 | 2006-07-18 |
| 1669442828 | James Michael Solomon | Dentist | 244 Hydraulic Ridge Road, Charlottesville, VA 22901 | 2006-01-23 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22911 |
Please comment or provide details below to improve the information on CHARLOTTESVILLE ORAL SURGERY AND DENTAL IMPLANT CENTER, LLC.
| 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.