MID-ATLANTIC CENTER FOR ORAL & MAXILLOFACIAL SURGERY LLC (NPI# 1184166803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184166803 |
| Entity Type | Organization |
| Organization Name | MID-ATLANTIC CENTER FOR ORAL & MAXILLOFACIAL SURGERY LLC |
| Practice Address |
8466 Herring Run Rd Suite D Seaford DE 19973-5763 |
| Practice Telephone | 3026293588 |
| Practice Fax Number | 3026290440 |
| Mailing Telephone | 3026293588 |
| Mailing Fax Number | 3026290440 |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2017-03-16 |
| Authorized Official Name | ERIC SPENCER (OWNER) |
| Authorized Official Telephone | 3026293588 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | DE | Dental Providers | |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DE | Dental Providers |
| Street Address |
8466 HERRING RUN RD SUITE D |
| City | SEAFORD |
| State | DE |
| Zip Code | 19973-5763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760466080 | Thomas R Mullen | Dentist | 8466 Herring Run Rd, Ste D, Seaford, DE 19973 | 2005-11-30 |
| 1144355173 | Thomas R. Mullen, Dmd, Pa | Dentist | 8466 Herring Run Rd, Suite D, Seaford, DE 19973-5763 | 2007-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831718972 | Deepa Abhilash | Nurse Practitioner | Nanticoke Memorial Hospital, 801, Middleford Rd, Milford, DE 19973 | 2020-04-09 |
| 1215477997 | Ekta Sharma | Physical Therapist | 715 King Street, Lofland Park Center, Seaford, DE 19973 | 2017-03-01 |
| 1497126981 | Christopher M. Heisey | Podiatrist | 543 N Shipley St Ste C, Seaford, DE 19973 | 2015-10-09 |
| 1083035026 | Angela Childs | Radiologic Technologist | 801 Road 535, Seaford, DE 19973 | 2013-12-18 |
| 1831531375 | Jennifer Willis-lal | Physical Therapist | 28091 Barley Run, Seaford, DE 19973 | 2013-07-25 |
| 1972820017 | Pain Treatment and Anesthesia Management Services, LLC | Pain Medicine | 400 Health Services Dr Ste 401, Seaford, DE 19973 | 2010-04-29 |
| 1275737652 | Ronald Concha Parra | Internal Medicine | 701 Middleford Road, Seaford, DE 19973 | 2007-06-12 |
| 1013034172 | Jiloca Dejesus Jiloca Mdpa | Family Medicine | 105 A Front Street, Seaford, DE 19973 | 2007-03-23 |
| 1922122043 | Carla K. Linder | Counselor | 109 Rivers End Dr., Seaford, DE 19973 | 2007-03-16 |
| 1558494385 | Edwin J Juste | Chiropractor | 608 North Porter Street, Seaford, DE 19973 | 2007-03-13 |
| Find all providers in zip 19973 | ||||
| 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 |
|---|---|---|---|---|
| 1760466080 | Thomas R Mullen | Dentist | 8466 Herring Run Rd, Ste D, Seaford, DE 19973 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548705197 | Petrunich Oral Surgery | Dentist | 2444 Pulaski Hwy # 100, Newark, DE 19702-3906 | 2017-01-05 |
| 1972948198 | Michael David D'amico | Dentist | 4735 Ogletown Stanton Rd Ste 1115, Newark, DE 19713-2089 | 2013-05-01 |
| 1063744795 | Southern De Associates of Oral & Maxillofacial Surgery | Dentist | 126 West Front St., Frederica, DE 19946 | 2010-02-05 |
| 1801001516 | David Dieu | Dentist | 1202 Foulk Road, Wilmington, DE 19803 | 2007-05-14 |
| 1598889438 | Samuel C Nwogu | Dentist | 200 Biddle Ave Ste 214, Newark, DE 19702-3966 | 2007-03-17 |
| 1033257530 | Douglas Lynn Ditty | Dentist | 1004 S State St Ste 1, Dover, DE 19901-6901 | 2007-02-05 |
| 1558452177 | Oral & Maxillofacial Surgery Associates, P.a. | Dentist | 1304 N Broom St, Wilmington, DE 19806-4254 | 2006-09-27 |
| 1437250008 | Norman M Lippman | Dentist | 712 S Governors Ave, Dover, DE 19904 | 2006-09-26 |
| 1982625547 | David B. Ettinger | Dentist | 131 E Chestnut Hill Rd, Newark, DE 19713-4043 | 2006-07-21 |
| 1912940602 | Peter Francis Subach | Dentist | 1601 Milltown Rd Suite 17, Wilmington, DE 19808 | 2006-06-13 |
| Find all providers with the same taxonomy | ||||
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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.