HUNTSVILLE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PC (NPI# 1386740140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386740140 |
| Entity Type | Organization |
| Organization Name | HUNTSVILLE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PC |
| Practice Address |
2314 Pansy St Sw Huntsville AL 35801-3803 |
| Practice Telephone | 2565345028 |
| Practice Fax Number | 2565345073 |
| Mailing Telephone | 2565345028 |
| Mailing Fax Number | 2565345073 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-08-15 |
| Authorized Official Name | DR. PHILIP BRENT ELLEDGE (OWNER) |
| Authorized Official Telephone | 2565345028 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5313 | AL | Dental Providers |
| Street Address |
2314 PANSY ST SW |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35801-3803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437114246 | Philip B Elledge | Oral & Maxillofacial Surgery | 2314 Pansy St Sw, Huntsville, AL 35801-3803 | 2006-04-18 |
| 1104881721 | Jim B Duke Jr. | Oral & Maxillofacial Surgery | 2314 Pansy St Sw, Huntsville, AL 35801-3803 | 2006-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422742 | Elena Mihaela Kruse | Nurse Practitioner | 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 | 2020-09-18 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1003472978 | Gina Marie Delgado | Nurse Practitioner | Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 | 2019-05-15 |
| 1366909863 | Lisa Starkey Suggs | Nurse Practitioner | 3500 Memorial Parkway S.w., Huntsville, AL 35801 | 2019-02-21 |
| 1902373277 | Kelly S Fisher LLC | Counselor | 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 | 2018-10-25 |
| 1073097911 | Brittani B Hamrick | Psychologist | 203 Eastside Sq Ste C9, Huntsville, AL 35801 | 2018-09-17 |
| 1548748312 | Jane O. Orton, Licsw, LLC | Social Worker | 120 Holmes Ave Ne, Huntsville, AL 35801 | 2018-08-02 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1366968398 | Bennett Brent Smith | Physician Assistant | 825 Adams St. Se, Huntsville, AL 35801 | 2017-08-22 |
| Find all providers in zip 35801 | ||||
| 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 |
|---|---|---|---|---|
| 1871823963 | Cecil Rosco Shrewsberry Iv | Dentist | 3231 Woodward Dr Ste B, Huntsville, TX 77340-4101 | 2010-01-12 |
| 1275540635 | John Bondurant Harrison | Dentist | 213 Green Cove Rd Se, Huntsville, AL 35803-3005 | 2006-08-01 |
| 1447214424 | Gary W Hudson | Dentist | 1105 Eagletree Ln Se, Huntsville, AL 35801-6447 | 2006-04-14 |
| 1205804721 | Jason R Miller | Dentist | 910 Adams St Se Ste 215, Huntsville, AL 35801-3759 | 2006-03-10 |
| 1962497040 | Carl Wayne Myers | Dentist | 2317 Whitesburg Dr S, Huntsville, AL 35801-3819 | 2005-09-15 |
| 1558360826 | Stephen Earl Davis | Dentist | 1320 Windsor St, Huntsville, TX 77340-5616 | 2005-07-19 |
| 1346532611 | Jason R. Miller, D.m.d., M.d., P.C. | Dentist | 910 Adams St Se, Ste. 215, Huntsville, AL 35801-3730 | 2011-05-05 |
| 1811171754 | Landon D. Mclain | Dentist | 2045 Cecil Ashburn Dr Se, Suite 101, Huntsville, AL 35802-2563 | 2007-12-27 |
| 1932325677 | Gary W. Hudson, Dmd, Md, PC | Dentist | 1105 Eagletree Ln Se, Huntsville, AL 35801-6447 | 2007-04-18 |
| 1497970222 | David Joseph Furman | Dentist | 500 Whitesport Dr Sw, Suite #1, Huntsville, AL 35801-6451 | 2007-04-16 |
| Find all providers in HUNTSVILLE | ||||
| City | HUNTSVILLE |
| Zip Code | 35801 |
Please comment or provide details below to improve the information on HUNTSVILLE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PC.
| 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.