MANDALAI ORAL AND MAXILLOFACIAL SURGERY PC (NPI# 1760007678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760007678 |
| Entity Type | Organization |
| Organization Name | MANDALAI ORAL AND MAXILLOFACIAL SURGERY PC |
| Practice Address |
720 S. Brom Drive Suite 103 Naperville IL 60540 |
| Mailing Address |
479 N Harlem Ave Apt 1326 Oak Park IL 60301-6420 |
| Practice Telephone | 6302124748 |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |
| Authorized Official Name | DR. MOHAMMED ALMANDALAWI (DOCTOR) |
| Authorized Official Telephone | 9093670744 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
720 S. BROM DRIVE SUITE 103 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316418957 | James Edward Frank | Counselor | 600 South Washington Street, Suite 302, Naperville, IL 60540 | 2018-12-07 |
| 1093208332 | Ingrid Johnson | Developmental Therapist | Right Start Pediatric Therapies, 50 S Main St Suite 200, Naperville, IL 60540 | 2018-06-12 |
| 1225528524 | Tara Rada Nieberding | Contractor | 1701 Quincy Ave Ste 12, Naperville, IL 60540 | 2018-05-14 |
| 1588182190 | Debra Xiangjun Hayes | Acupuncturist | 226 N Washington St # 2, Naperville, IL 60540 | 2017-09-03 |
| 1487197166 | Health Improvement and Preventive Services LLC | Family Medicine | 1979 Mcdowell Rd., Suite 103, Naperville, IL 60540 | 2016-11-29 |
| 1588013775 | Matthew Jacob Imber | Chiropractor | 1220 Hobson Rd Ste 220, Naperville, IL 60540 | 2016-06-08 |
| 1457711418 | Elite Pain Medical Group Inc | Physical Medicine & Rehabilitation | 720 South Brom Drive, Suite 201, Naperville, IL 60540 | 2016-03-03 |
| 1265814800 | Jenifer Lynn Mersman | Chiropractor | 475 River Bend Rd. Suite 104, Naperville, IL 60540 | 2015-06-19 |
| 1386038016 | Jonathon Martin Ruiz | Specialist/Technologist | 440 N Brainard Street, Naperville, IL 60540 | 2015-03-19 |
| 1841681129 | Sara Alison Furlette-koski | Specialist/Technologist | 450 S. Brainard St., North Central College, Naperville, IL 60540 | 2015-02-09 |
| Find all providers in zip 60540 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114025574 | Michael John Karakourtis | Oral & Maxillofacial Surgery | 720 S Brom Drive, Suite #103, Naperville, IL 60540-6595 | 2006-09-20 |
| 1255605580 | Michael J Karakourtis Dds Ltd. | Oral & Maxillofacial Surgery | 720 Brom Ct, Suite 103, Naperville, IL 60540-6595 | 2012-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821652736 | Oral and Maxilloficial Head and Neck Associates LLC | Oral & Maxillofacial Surgery | 811 West Wellington Avenue, Attention: Mohammed Qaisi, Md., Dmd., Chicago, IL 60657-5123 | 2019-04-25 |
| 1801000443 | Center for Oral and Maxillofacial Surgery, P.C. | Oral & Maxillofacial Surgery | 10200 W Main St, Signal Hill Medical Bldg, Belleville, IL 62223-1408 | 2007-05-10 |
| 1396899878 | Bradley W Roberts Dmd PC | Oral & Maxillofacial Surgery | 4 Professional Drive, Alton, IL 62002 | 2007-01-22 |
| 1922198118 | Glenn A Miller | Oral & Maxillofacial Surgery | 10200 West Main Street, Signal Hill Medical Building, Belleville, IL 62223-1495 | 2006-10-16 |
| 1356448344 | William Joseph Powell | Oral & Maxillofacial Surgery | 318 S Washington St, Hinsdale, IL 60521-4433 | 2006-09-20 |
| 1295840304 | Khaled Abughazaleh | Oral & Maxillofacial Surgery | 65 E Scott St Apt 9a, Chicago, IL 60610-5274 | 2006-08-20 |
| 1750360608 | Michael R Stohle | Oral & Maxillofacial Surgery | 500 Davis St, Ste 509, Evanston, IL 60201 | 2006-01-10 |
| 1124027990 | Gamal S Naguib | Oral & Maxillofacial Surgery | 302 E Saint Charles Rd, Villa Park, IL 60181-2420 | 2005-07-14 |
| 1518528165 | Ali Al-qudsi | Oral & Maxillofacial Surgery | 1901 W Harrison St, Chicago, IL 60612-3714 | 2019-06-25 |
| 1669033445 | Brett Quinto | Oral & Maxillofacial Surgery | 1901 W Harrison St, Chicago, IL 60612-3714 | 2019-06-24 |
| Find all providers with the same taxonomy | ||||
| City | NAPERVILLE |
| Zip Code | 60540 |
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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.