GREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI - NPI 1184506693 - Oral & Maxillofacial Surgery in Summerville, SC

Q: What is the provider's specialty?

The provider's specialty is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

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About Greenville Oral Maxillofacial Surgery, P.a., A South Carolina Professi NPPES

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

GREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI (NPI 1184506693), doing business as Summerville Oral Surgery, is a healthcare organization registered as an oral & maxillofacial surgery in Summerville, South Carolina and active in the NPI registry since July 2025. The organization lists Tina A Hicks, Billing, as its authorized official.

NPPES Registry Identity

NPI1184506693

Entity TypeOrganization

Primary Taxonomy204E00000X

Legal Business NameGREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI

Location Address403 W 4TH NORTH ST UNIT ASummerville, SC 29483-6552

Mailing Address403 W 4th North St Unit ASummerville, SC 29483-6552

Phone(843) 821-7583

Organization SubpartYes

Authorized OfficialTina A HicksBilling · (864) 216-7924

Enumeration DateJuly 24, 2025

NPPES CertifiedJuly 24, 2025

✔ NPI 1184506693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code204E00000X

Definition

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.

403 W 4TH NORTH ST UNIT A, Summerville, SC 29483

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Other Names 1

Doing Business AsSummerville 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

What is GREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI's NPI number?

The NPI number assigned to this healthcare provider is 1184506693, enumerated as an "organization" on July 24, 2025.

Where is the provider located?

The provider is located at 403 W 4TH NORTH ST UNIT A SUMMERVILLE, SC 29483 and the phone number is (843) 821-7583.

What is the provider's specialty?

Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

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