SHORE ORAL MAXILLO SURGERY GROUP PA (NPI# 1619104015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619104015 |
| Entity Type | Organization |
| Organization Name | SHORE ORAL MAXILLO SURGERY GROUP PA |
| Practice Address |
301 Madison Ave Lakewood NJ 08701-3266 |
| Practice Telephone | 7323674042 |
| Practice Fax Number | 7329059210 |
| Mailing Telephone | 7323674042 |
| Mailing Fax Number | 7329059210 |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2009-06-12 |
| Authorized Official Name | DR. RICHARD L GAINES (OWER) |
| Authorized Official Telephone | 7323674042 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DI09103 | NJ | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 1642006 | 05 |
| Street Address |
301 MADISON AVE |
| City | LAKEWOOD |
| State | NJ |
| Zip Code | 08701-3266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346297975 | Ira Kreitman | Dentist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2006-05-28 |
| 1073170619 | Natalie Werner | Speech-Language Pathologist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2019-05-20 |
| 1780041004 | Malka J Nussbaum | Speech-Language Pathologist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2016-01-16 |
| 1871991208 | Rochel Mikel | Speech-Language Pathologist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2014-12-17 |
| 1386957710 | Vladimir Kleyman | Pharmacist | 301 Madison Ave, Suite 7, Lakewood, NJ 08701-3266 | 2010-07-14 |
| 1154648277 | Joseph Polinsky | Dentist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2010-04-29 |
| 1114244878 | Prescriptions R Us | Pharmacy | 301 Madison Ave, Ste 7, Lakewood, NJ 08701-3266 | 2010-04-21 |
| 1063613297 | Michael Neiman | Dentist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2007-05-28 |
| 1518177377 | Joseph Polinsky Dmd LLC | Dentist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2007-05-23 |
| 1194935312 | Robert L Golden | Dentist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2007-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639787393 | Sky Care Aba LLC | Social Worker | 41 Carasaljo Drive, Lakewood, NJ 08701 | 2020-07-20 |
| 1487276325 | Teresa Rose Alvarez | Counselor | 1215 Nj-70 W, Lakewood, NJ 08701 | 2020-05-14 |
| 1417588468 | Miriam Pelberg | Behavioral Analyst | 519 Second St., Lakewood, NJ 08701 | 2020-01-29 |
| 1639700529 | Rivky Parnes | Occupational Therapy Assistant | 110 Hillside Bullivard, Lakewood, NJ 08701 | 2020-01-29 |
| 1659910172 | Esther Gold | Behavioral Analyst | 611 Stirling Ave A, Lakewood Township, NJ 08701 | 2020-01-01 |
| 1649816323 | Julie Mcculley | Orthotist | 1353 River Ave Suite #4, Lakewood, NJ 08701 | 2019-11-18 |
| 1356990782 | Lucy Dimeglio | Technician | 17 Amberlands Court, Lakewood, NJ 08701 | 2019-09-09 |
| 1992262299 | Miriam Lichtschein | Speech-Language Pathologist | 1439 South Street, Lakewood, NJ 08701 | 2019-02-23 |
| 1407326531 | Achievements Early Intervention Services | Community/Behavioral Health | 85a Gladiola Ct, Lakewood, NJ 08701 | 2018-12-02 |
| 1871062224 | Ms Optical LLC | Eyewear Supplier (Equipment, not the service) | 12 America Ave, 1a, Lakewood, NJ 08701 | 2018-11-15 |
| Find all providers in zip 08701 | ||||
| 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 |
|---|---|---|---|---|
| 1194865907 | David William Todd | Dentist | 120 Southwestern Dr, Lakewood, NY 14750 | 2007-02-08 |
| 1972606903 | Nicholas C Diamantis | Dentist | 14700 Detroit Ave, Lakewood, OH 44107 | 2006-09-06 |
| 1407885601 | Urban Michael Picard | Dentist | 15711 Madison Ave Ste 104, Lakewood, OH 44107-5655 | 2006-07-01 |
| 1730156126 | Joseph C Piotrowski | Dentist | 400 Madison Ave, Lakewood, NJ 08701-3214 | 2006-03-03 |
| 1083153985 | Cle Oms Lakewood/rocky River - Jeffrey W. Kosman Dds Inc. | Dentist | 15711 Madison Ave, Suite 104, Lakewood, OH 44107-5655 | 2017-02-13 |
| 1144561002 | Brian K. Smith, D.d.s., M.d., Inc. | Dentist | 14701 Detroit Ave, Suite 333, Lakewood, OH 44107-4109 | 2013-03-01 |
| 1881946309 | Peak Oral & Maxillofacial Surgery Center | Dentist | 2290 Kipling St, Suite 2, Lakewood, CO 80215-1578 | 2012-10-08 |
| 1821256504 | Haeman Noori | Dentist | 2290 Kipling St, Suite 2, Lakewood, CO 80215-1578 | 2008-05-29 |
| 1356567606 | Urban M. Picard Dds, Inc | Dentist | 15711 Madison Ave, Suite #104, Lakewood, OH 44107-5655 | 2007-04-17 |
| 1689797086 | Donald A Decino, D.d.s., P,c | Dentist | 3405 S Yarrow St, Suite A, Lakewood, CO 80227-4965 | 2007-04-09 |
| Find all providers in LAKEWOOD | ||||
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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.