COLUMBUS ORAL & MAXILLOFACIAL SURGERY PC (NPI# 1003023870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1003023870 |
Entity Type | Organization |
Organization Name | COLUMBUS ORAL & MAXILLOFACIAL SURGERY PC |
Practice Address |
4405 N Stadium Dr Suite A Columbus GA 31909-1878 |
Mailing Address |
4405 N Stadium Dr Suite A Columbus GA 31909-1875 |
Practice Telephone | 7065070901 |
Practice Fax Number | 7065070984 |
Mailing Telephone | 7065070901 |
Mailing Fax Number | 7065070984 |
Enumeration Date | 2007-05-17 |
Last Update Date | 2008-06-23 |
Authorized Official Name | DR. JOHN R SCUBA (OWNER) |
Authorized Official Telephone | 7065070901 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN013256 | GA | Dental Providers |
N | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
052372 | GA | Allopathic & Osteopathic Physicians |
Y | 204E00000X | Oral & Maxillofacial Surgery | 052372 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | BCBS OF GA (M) GROUP | IP09476001 | 01 |
Street Address |
4405 N STADIUM DR SUITE A |
City | COLUMBUS |
State | GA |
Zip Code | 31909-1878 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063828499 | Columbus Children's Dentistry, PC | Dentist | 4405 N Stadium Dr, Suite B, Columbus, GA 31909-1878 | 2014-07-07 |
1043413032 | Jeffrey M Serff | Dentist | 4405 N Stadium Dr, Suite B, Columbus, GA 31909-1875 | 2007-06-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235747403 | Abundant Heart Healthcare Solution, LLC | Adult Companion | 6361 Talokas Lane, Ste C 140-279, Columbus, GA 31909 | 2020-07-14 |
1477185791 | Shandis Denise Phaneuf | Licensed Practical Nurse | 6545 Gregg Dr, Columbus, GA 31909 | 2020-02-05 |
1164086203 | Brock Musick | Physical Therapist | 100 First Court, Columbus, GA 31909 | 2019-04-24 |
1407340037 | Courtney Patterson | Behavior Technician | 5900 Warm Springs Road, Suite J, Columbus, GA 31909 | 2018-06-18 |
1225543515 | Oral & Facial Surgery of East Alabama, LLC | Dentist | 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | 2017-12-08 |
1528577368 | Courtney Anne Young | Nurse Practitioner | 2700 Double Churches Rd, Apt 1207, Columbus, GA 31909 | 2017-09-25 |
1427573542 | Megan Renee Kwon | Dietitian, Registered | 4343 Warm Springs Road Apt. 110, Columbus, GA 31909 | 2017-08-09 |
1942659305 | Stephanie Mcghee | Dental Hygienist | 4835 Turnberry Lane, Columbus, GA 31909 | 2016-06-07 |
1770932162 | Tammy Allen | Dental Assistant | 701 Hoff Rd Building 9240, Ft. Benning, GA 31909 | 2016-06-07 |
1003265406 | Rhonda Mills | Dental Assistant | 7101 Hoff Rd Building 9240, Ft. Benning, GA 31909 | 2016-06-07 |
Find all providers in zip 31909 |
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 |
---|---|---|---|---|
1831543701 | East Columbus Oral Surgery Specialists Inc. | Oral & Maxillofacial Surgery | 6555 E Broad St., Columbus, OH 43213 | 2016-04-18 |
1265855795 | Premier Interventional Pain of Ohio LLC | Oral & Maxillofacial Surgery | 793 W State St, Columbus, OH 43222-1551 | 2014-02-04 |
1699196022 | Premier Anesthesia of Ohio LLC | Oral & Maxillofacial Surgery | 793 W State St, Columbus, OH 43222-1551 | 2014-01-03 |
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 |
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 |
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 |
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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.