WICHITA ORAL SURGERY LLC (NPI# 1164914982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164914982 |
| Entity Type | Organization |
| Organization Name | WICHITA ORAL SURGERY LLC |
| Practice Address |
12611 E 21st St N Wichita KS 67206-3594 |
| Practice Telephone | 3167421506 |
| Practice Fax Number | 3167421507 |
| Mailing Telephone | 3167421506 |
| Mailing Fax Number | 3167421507 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |
| Authorized Official Name | ANGELIKA ROE (CREDENTIALING) |
| Authorized Official Telephone | 8882471869 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Street Address |
12611 E 21ST ST N |
| City | WICHITA |
| State | KS |
| Zip Code | 67206-3594 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1174006613 | Courtney Dawn Simon | Physical Therapist | 9360 E Central Ave Ste 100, Wichita, KS 67206 | 2018-09-11 |
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1750804597 | Katelyn Aguiar | Psychologist | 250 N Rock Rd Ste 210, Wichita, KS 67206 | 2017-07-24 |
| 1457888778 | Mona Kay Cherryholmes | Social Worker | 1223 N. Rock Rd, Bldg A. Suite 100, Wichita, KS 67206 | 2017-05-17 |
| 1164899415 | Elizabeth Herl | Marriage & Family Therapist | 250 N Rock Rd Ste 150, Wichita, KS 67206 | 2015-08-21 |
| 1851715510 | Ndjj Corp | Custodial Care Facility | 6403 E Marjore, Wichita, KS 67206 | 2014-02-14 |
| 1801238217 | Courtney Ann Lang | Physical Therapist | 1603 North Chapel Hill Street, Suite 400, Wichita, KS 67206 | 2013-07-26 |
| 1194063032 | Peak Performance Health Pa | Chiropractor | 10111 E 21st St, #106, Wichita, KS 67206 | 2013-01-28 |
| 1750629002 | Rachel Marie Conrad | Speech-Language Pathologist | 1861 N. Rock Rd, Ste 101, Wichita, KS 67206 | 2013-01-22 |
| Find all providers in zip 67206 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| 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 |
|---|---|---|---|---|
| 1871014738 | Christopher M. Harris, Dmd, Md, Pa | Clinic/Center | 1919 N Webb Rd, Wichita, KS 67206-3405 | 2017-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598998130 | Shawnee Oral Surgery, Lc | Clinic/Center | 6844 Silverheel Street, Shawnee, KS 66226-5300 | 2009-08-31 |
| 1548432628 | Southwest Oral & Maxillofacial Surgery LLC | Clinic/Center | 311 Campus Dr, Suite 101, Garden City, KS 67846-6294 | 2008-03-28 |
| 1043629264 | Manhattan Oral Surgery & Implant Center | Clinic/Center | 1133 College Ave, C200, Manhattan, KS 66502-2770 | 2014-08-13 |
| 1144304643 | Oral Surgery Kansas, Lc | Clinic/Center | 308 Maine St, Lawrence, KS 66044 | 2006-10-24 |
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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.