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NOVA ORAL SURGERY LLC
NPI 1225747736
Dentist - Oral and Maxillofacial Surgery in Ada, OK

Active since November 23, 2022
803 N MONTE VISTA ST, ADA, OK 74820(580) 332-3010(580) 332-3010 Get Directions Write a Review

NPPES record last updated: November 23, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nova Oral Surgery Llc NPPES

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

NOVA ORAL SURGERY LLC (NPI 1225747736), doing business as Southeast Oklahoma Oral And Maxillofacial, is a healthcare organization registered as an oral and maxillofacial surgery in Ada, Oklahoma and active in the NPI registry since November 2022. The organization maintains 2 additional practice locations and lists Hans Charles Igou, Owner, as its authorized official.

NPPES Registry Identity

NPI1225747736
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameNOVA ORAL SURGERY LLC
Location Address803 N MONTE VISTA STAda, OK 74820-7711
Mailing Address803 N Monte Vista StAda, OK 74820-7711 · (580) 332-3010 · Fax (580) 332-1302
Phone(580) 332-3010
Fax(580) 332-3010
Organization SubpartNo
Authorized OfficialHans Charles IgouOwner · (580) 332-3010
Enumeration DateNovember 23, 2022
NPPES CertifiedNovember 23, 2022
✔ NPI 1225747736 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.

803 N MONTE VISTA ST, Ada, OK 74820
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Other Names 1

Doing Business AsSoutheast Oklahoma Oral And Maxillofacial

Secondary Practice Locations 2

Location 11609 N Strong Blvd Ste 100McAlester, OK 74501-3881 · Phone (918) 426-3244 · Fax (918) 426-3254
Location 2700 S Mustang RdYukon, OK 73099-6777 · Phone (405) 494-7227

Other Identifiers 1

Medicaid200485650AOK

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

Other Providers at the Same Location NPPES 3

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

DR. RICHARD TODD BOONE DDS
Dentist (Oral and Maxillofacial Surgery)
803 N MONTE VISTA ST
ADA, OK 74820
Pontotoc County (580) 332-3010
SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC
Dentist (Oral and Maxillofacial Surgery)
803 N MONTE VISTA ST
ADA, OK 74820
Pontotoc County (580) 332-3010
DR. HANS CHARLES IGOU D.D.S.
Dentist
803 N MONTE VISTA ST
ADA, OK 74820
Pontotoc County (580) 332-3010

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 Nova Oral Surgery LLC's NPI number?

The NPI number for Nova Oral Surgery LLC is 1225747736. It was assigned to this organization in the NPPES registry on November 23, 2022. The provider is doing business as Southeast Oklahoma Oral and Maxillofacial.

Where is Nova Oral Surgery LLC located?

Nova Oral Surgery LLC is located at 803 N Monte Vista St, Ada, OK 74820. The listed phone number is (580) 332-3010.

What is Nova Oral Surgery 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 Nova Oral Surgery LLC was last updated on November 23, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.