ORAL AND MAXILLOFACIAL SURGERY CENTER OF LAFAYETTE (NPI# 1154411163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154411163 |
| Entity Type | Organization |
| Organization Name | ORAL AND MAXILLOFACIAL SURGERY CENTER OF LAFAYETTE |
| Practice Address |
2020 Union Street Suite 200 Lafayette IN 47904 |
| Practice Telephone | 7654468808 |
| Practice Fax Number | 7654469567 |
| Mailing Telephone | 7654468808 |
| Mailing Fax Number | 7654469567 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2009-02-27 |
| Authorized Official Name | COURTNEY A JAMES (OFFICE MANAGER) |
| Authorized Official Telephone | 7654468808 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
2020 UNION STREET SUITE 200 |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1780824433 | Joel R Dragoo | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2009-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
| 1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
| 1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
| 1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
| 1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
| 1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
| 1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
| 1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
| 1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
| 1609968254 | Greater Lafayette Health Services | Clinic/Center | 1000 North 18th Street, Lafayette, IN 47904 | 2006-09-29 |
| Find all providers in zip 47904 | ||||
| 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 |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1578089603 | Ardoin-kennedy LLC | Dentist | 203 A Energy Parkway, Lafayette, LA 70508 | 2017-08-21 |
| 1154864106 | Coal Creek Oral Surgery and Dental Implant Center, Pllc | Dentist | 1771 Cherokee Trl, Lafayette, CO 80026-7088 | 2016-11-23 |
| 1063629988 | Brett A Henrikson | Dentist | 2 Executive Dr Ste A, Lafayette, IN 47905-4859 | 2007-05-17 |
| 1316169030 | Hiram A. Mcconnell | Dentist | 1231 Coolidge Blvd, Lafayette, LA 70503-2620 | 2007-05-03 |
| 1861523441 | Bruce A Schneider | Dentist | 117 Rue Fontaine, Lafayette, LA 70508-5744 | 2007-03-08 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1093808594 | Keith R. Gronbach, D.d.s., Inc. | Dentist | 3799 Mt Diablo Blvd, Lafayette, CA 94549-3538 | 2006-10-02 |
| 1104920453 | Christian Matthew Steffey | Dentist | 2020 Union St Ste 200, Lafayette, IN 47904-2694 | 2006-09-08 |
| 1780600031 | Mark Alan Welch | Dentist | 200 Republic Ave, I, Lafayette, LA 70508-6826 | 2006-07-13 |
| Find all providers in LAFAYETTE | ||||
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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.