MID-KANSAS ORAL & MAXILLOFACIAL SURGERY, LLC (NPI# 1881258366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881258366 |
| Entity Type | Organization |
| Organization Name | MID-KANSAS ORAL & MAXILLOFACIAL SURGERY, LLC |
| Practice Address |
3510 N Ridge Rd Ste 500 Wichita KS 67205-1226 |
| Practice Telephone | 3167220800 |
| Practice Fax Number | 3167225822 |
| Mailing Telephone | 3167220800 |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2019-11-12 |
| Authorized Official Name | JOHN D GAGNON (MEMBER) |
| Authorized Official Telephone | 3167220800 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10111 E 21st St N Ste 107, Wichita, KS 672063555 | 3167220800 |
| Street Address |
3510 N RIDGE RD STE 500 |
| City | WICHITA |
| State | KS |
| Zip Code | 67205-1226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134505399 | Myles Davidson | Dentist | 3510 N Ridge Rd Ste 500, Wichita, KS 67205 | 2015-08-10 |
| 1619461027 | Joseph R Tingey, Dds, Pa | Dentist | 3510 N Ridge Rd Ste 500, Wichita, KS 67205-1226 | 2018-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295211910 | Emily M Chastain | Dentist | 3213 N. Ridge Rd, Wichita, KS 67205 | 2018-07-16 |
| 1811415466 | Awaken Psychology LLC | Clinic/Center | 2552 N Maize Ct Suite 600, Wichita, KS 67205 | 2017-09-05 |
| 1962940288 | Moc Wichita LLC | Assisted Living Facility | 7057 W Village Circle, Wichita, KS 67205 | 2017-02-07 |
| 1003362732 | Moc Wichita, LLC | Assisted Living Facility | 7057 West Village Circle, Wichita, KS 67205 | 2016-09-01 |
| 1649637653 | Abigail Friend | Audiologist-Hearing Aid Fitter | 2558 Lake Way Circle, Wichita, KS 67205 | 2016-01-21 |
| 1093121097 | The Eye Gallery, LLC | Optometrist | 3084 N. Maize Rd, Wichita, KS 67205 | 2014-07-10 |
| 1922428721 | Sam's West, Inc. | Technician/Technologist | 3084 N. Maize Road, Witchita, KS 67205 | 2014-04-18 |
| 1447693627 | Caryn Rana Landreth | Social Worker | 3114 N Brush Creek St, Wichita, KS 67205 | 2013-04-08 |
| 1902182686 | Return To Motion Medical | Durable Medical Equipment & Medical Supplies | 3221 N Ridge Port Circle, Wichita, KS 67205 | 2011-10-26 |
| 1164739843 | Stephanie Kay Oakman | Nurse Practitioner | 3460 N Ridge Rd Ste 90, Wichita, KS 67205 | 2010-09-01 |
| Find all providers in zip 67205 | ||||
| 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 |
|---|---|---|---|---|
| 1356683213 | Prime Healthcare Physician Services - Providence Inc | Oral & Maxillofacial Surgery | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2013-03-19 |
| 1386963718 | Melissa Mae Moutray | Oral & Maxillofacial Surgery | 311 Campus Drive, Suite 101, Garden City, KS 67846 | 2010-05-25 |
| 1417016270 | Thomas Howard Faerber | Oral & Maxillofacial Surgery | 4601 W 109th St, Suite 118, Overland Park, KS 66211-1318 | 2006-12-07 |
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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.