SOUTHEASTERN PA ORAL SURGERY LLC
NPI 1073641148
Dentist - Oral and Maxillofacial Surgery in Philadelphia, PA
About Southeastern Pa Oral Surgery Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHEASTERN PA ORAL SURGERY LLC (NPI 1073641148) is a healthcare organization registered as an oral and maxillofacial surgery in Philadelphia, Pennsylvania and active in the NPI registry since March 2007. The organization maintains a secondary practice location in Philadelphia and lists Brian M Smith, Chairman, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southeastern Pa Oral Surgery Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Southeastern PA Oral Surgery LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Delaware Valley Maxillofacial & Oral Surgery LLC's NPI number?
The NPI number for Delaware Valley Maxillofacial & Oral Surgery LLC is 1073641148. It was assigned to this organization in the NPPES registry on March 1, 2007. The provider is doing business as Southeastern PA Oral Surgery LLC.
Where is Delaware Valley Maxillofacial & Oral Surgery LLC located?
Delaware Valley Maxillofacial & Oral Surgery LLC is located at 2301 E Allegheny Ave Ste 206, Philadelphia, PA 19134. The listed phone number is (267) 367-5009.
What is Delaware Valley Maxillofacial & Oral Surgery LLC's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Delaware Valley Maxillofacial & Oral Surgery LLC enrolled in Medicare?
Yes. Delaware Valley Maxillofacial & Oral Surgery LLC is registered in the Medicare PECOS enrollment system.
When is Delaware Valley Maxillofacial & Oral Surgery LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Pennsylvania, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Delaware Valley Maxillofacial & Oral Surgery LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Delaware Valley Maxillofacial & Oral Surgery LLC, in Maxillofacial Surgery and Oral Surgery. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Delaware Valley Maxillofacial & Oral Surgery LLC accept?
Health plans from DentaQuest list Delaware Valley Maxillofacial & Oral Surgery LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Delaware Valley Maxillofacial & Oral Surgery LLC was last updated on August 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Southeastern Pa Oral Surgery Llc · NPI 1073641148
Oral and Maxillofacial Surgery organization in Philadelphia, Pennsylvania. Organization record, active in the CMS NPPES registry since March 1, 2007.
## Identity
- **NPI:** 1073641148 (Entity type: Organization)
- **Enumerated:** March 1, 2007
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **Legal business name:** Delaware Valley Maxillofacial & Oral Surgery Llc
- **Organization subpart:** No
- **Authorized official:** Brian Smith, CHAIRMAN
## Practice location
- **Address:** 2301 E ALLEGHENY AVE STE 206, Philadelphia, PA 19134-4427
- **Phone:** (267) 367-5009 · **Fax:** (267) 367-5476
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Pennsylvania, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Maxillofacial Surgery (2), Oral Surgery (2); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 13, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1073641148) · Data from the CMS NPPES public registry.