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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SUMMIT ORAL SURGERY CENTER LLC
NPI 1114868957
Dentist - Oral and Maxillofacial Surgery in Independence, MO

Active since April 04, 2026
19921 E JACKSON DR, INDEPENDENCE, MO 64057(313) 600-2188 Get Directions Write a Review

NPPES record last updated: August 11, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 11, 2026, Apr 4, 2026 (2 updates tracked since 2026).

About Summit Oral Surgery Center Llc NPPES

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

SUMMIT ORAL SURGERY CENTER LLC (NPI 1114868957), doing business as Independence Surgery Center, is a healthcare organization registered as an oral and maxillofacial surgery in Independence, Missouri and active in the NPI registry since April 2026. The organization lists Michael Lee, Center Admin; Board Of Managers, as its authorized official.

NPPES Registry Identity

NPI1114868957
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameSUMMIT ORAL SURGERY CENTER LLC
Location Address19921 E JACKSON DRIndependence, MO 64057-1596
Mailing Address19921 E Jackson DrIndependence, MO 64057-1596 · (816) 271-0110
Phone(313) 600-2188
Organization SubpartNo
Authorized OfficialMichael LeeCenter Admin; Board Of Managers · (816) 271-0110
Enumeration DateApril 4, 2026
Last NPPES UpdateAugust 11, 20262 updates tracked since enumeration
NPPES CertifiedAugust 11, 2026
✔ NPI 1114868957 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.
19921 E JACKSON DR, Independence, MO 64057
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Other Names 1

Doing Business AsIndependence Surgery Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUMMIT ORAL SURGERY CENTER LLC
Clinic/Center (Ambulatory Surgical)
19921 E JACKSON DR
INDEPENDENCE, MO 64057
Jackson County (913) 735-3826

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 Summit Oral Surgery Center LLC's NPI number?

The NPI number for Summit Oral Surgery Center LLC is 1114868957. It was assigned to this organization in the NPPES registry on April 4, 2026. The provider is doing business as Independence Surgery Center.

Where is Summit Oral Surgery Center LLC located?

Summit Oral Surgery Center LLC is located at 19921 E Jackson Dr, Independence, MO 64057. The listed phone number is (313) 600-2188.

What is Summit Oral Surgery Center LLC'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 Summit Oral Surgery Center LLC was last updated on August 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.