SOUTH PARK ORAL SURGERY
NPI 1003502519
Dentist - Oral and Maxillofacial Surgery in Charlotte, NC

Q: What is South Park Oral Surgery's NPI number?

The NPI number for South Park Oral Surgery is 1003502519. It was assigned to this organization in the NPPES registry on April 17, 2023.

Q: What is South Park Oral Surgery's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since April 17, 2023

2719 COLTSGATE RD, CHARLOTTE, NC 28211(704) 366-8707(704) 366-8717 Get Directions Write a Review

NPPES record last updated: April 17, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About South Park Oral Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH PARK ORAL SURGERY (NPI 1003502519) is a healthcare organization registered as an oral and maxillofacial surgery in Charlotte, North Carolina and active in the NPI registry since April 2023. The organization lists Kevin P Bond, Dentist/owner, as its authorized official.

NPPES Registry Identity

NPI1003502519

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameSOUTH PARK ORAL SURGERY

Location Address2719 COLTSGATE RDCharlotte, NC 28211-3502

Mailing Address2719 Coltsgate RdCharlotte, NC 28211-3502 · (704) 366-8707 · Fax (704) 366-8717

Phone(704) 366-8707

Fax(704) 366-8717

Organization SubpartNo

Authorized OfficialKevin P BondDentist/owner · (704) 366-8707

Enumeration DateApril 17, 2023

NPPES CertifiedApril 17, 2023

✔ NPI 1003502519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Definition

An oral and maxillofacial surgery dentist specialized in 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.

2719 COLTSGATE RD, Charlotte, NC 28211

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Other Names 1

Doing Business AsSouth Park Oral Surgery

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South Park Oral Surgery's NPI number?

The NPI number for South Park Oral Surgery is 1003502519. It was assigned to this organization in the NPPES registry on April 17, 2023.

Where is South Park Oral Surgery located?

South Park Oral Surgery is located at 2719 Coltsgate Rd, Charlotte, NC 28211. The listed phone number is (704) 366-8707.

What is South Park Oral Surgery's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for South Park Oral Surgery was last updated on April 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.