SHENANDOAH ORAL AND MAXILLOFACIAL SURGERY INC (NPI# 1720316987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720316987 |
| Entity Type | Organization |
| Organization Name | SHENANDOAH ORAL AND MAXILLOFACIAL SURGERY INC |
| Other Organization Name | SHENANDOAH ORAL AND MAXILLOFACIAL SURGERY INC |
| Practice Address |
170 Garber Ln Suite 2 Winchester VA 22602-4386 |
| Practice Telephone | 5406670100 |
| Practice Fax Number | 5406670121 |
| Mailing Telephone | 5406670100 |
| Mailing Fax Number | 5406670121 |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |
| Authorized Official Name | DR. JAMES ALBERT PELL (PRESIDENT) |
| Authorized Official Telephone | 5406670100 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
6414 | VA | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
11829 | VA | Dental Providers |
| Other Name | Type Code |
|---|---|
| shenandoah oral and maxillofacial surgery inc | Doing Business As Name - Organization |
| Street Address |
170 GARBER LN SUITE 2 |
| City | WINCHESTER |
| State | VA |
| Zip Code | 22602-4386 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972940393 | Shenandoah Oral & Maxillofacial Surgery Inc | Dentist | 170 Garber Ln, Winchester, VA 22602-4386 | 2013-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689225534 | Tracey Lynn Graham | Nurse Practitioner | 202 Heath Ct, Winchester, VA 22602 | 2019-09-23 |
| 1104341197 | Ashley Grooms | Occupational Therapist | 183 Shields Dr, Winchester, VA 22602 | 2017-08-10 |
| 1275053183 | Im Just Me Movement | Local Education Agency (LEA) | 100 Asbury Ct, Winchester, VA 22602 | 2017-06-21 |
| 1750823043 | Crossroads Treatment Center of Winchester, PC | Community/Behavioral Health | 500 Pegasus Ct, Winchester, VA 22602 | 2016-11-17 |
| 1114399243 | Guardianlight of Northwestern Va Incorporated | Home Health | 3343 Valley Ave, Unit # 700, Winchester, VA 22602 | 2015-10-28 |
| 1679876171 | Medics Usa Medical Center | Clinic/Center | 290 Front Royal Pike, Winchester, VA 22602 | 2010-12-06 |
| 1679667216 | Rebecca Sue Isenhower | Psychologist | 174 Costello Drive, Winchester, VA 22602 | 2006-10-03 |
| 1548278310 | Brandon Terry Jennings | Pharmacist | 109 Lynnehaven Dr, Winchester, VA 22602 | 2006-08-04 |
| 1386690428 | Alla Yurievna Golovkina-hynes | Ophthalmology | 158 Front Royal Pike Ste 303, Winchester, VA 22602 | 2006-05-26 |
| 1174572283 | Abel C Borromeo V | Chiropractor | 125 Prosperity Dr, Suite 600, Winchester, VA 22602 | 2006-05-08 |
| Find all providers in zip 22602 | ||||
| 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 |
|---|---|---|---|---|
| 1972940393 | Shenandoah Oral & Maxillofacial Surgery Inc | Dentist | 170 Garber Ln, Winchester, VA 22602-4386 | 2013-05-24 |
| 1609162460 | Kool Smiles Van, PC | Dentist | 2065 S Pleasant Valley Rd, Winchester, VA 22601-7001 | 2011-06-21 |
| 1093882334 | David Eric Redmon | Dentist | 36 W Whitlock Ave, Winchester, VA 22601-4432 | 2006-11-30 |
| 1790763258 | John I. Gray, IIi, Dmd, Psc | Dentist | 1303 W Lexington Ave, Winchester, KY 40391-3100 | 2006-01-05 |
| 1578919445 | Margaret Pham | Dentist | 1010 Amherst St, Winchester, VA 22601-3308 | 2016-05-10 |
| 1679829311 | Winchester Oral Surgery Center PC | Dentist | 172 Linden Dr, Suite 111, Winchester, VA 22601-2891 | 2012-07-31 |
| 1447577069 | Eric Drew Starley | Dentist | 1010 Amherst St, Winchester, VA 22601-3308 | 2010-04-21 |
| 1255590188 | Valley Physician Enterprise, Inc | Dentist | 172 Linden Dr, Suite 111, Winchester, VA 22601-2891 | 2008-06-05 |
| 1154525574 | D. Eric Redmon, D.d.s. | Dentist | 36 W Whitlock Ave, Winchester, VA 22601-4432 | 2007-06-11 |
| 1376687541 | Vincent Franco Coviello | Dentist | 172 Linden Dr, Suite 111, Winchester, VA 22601-2891 | 2007-02-19 |
| Find all providers in WINCHESTER | ||||
| City | WINCHESTER |
| Zip Code | 22602 |
Please comment or provide details below to improve the information on SHENANDOAH ORAL AND MAXILLOFACIAL SURGERY INC.
| 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.