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SOUTH BEDFORD ORAL & MAXILLOFACIAL SURGERY PLLC
NPI 1275769929
Dentist - Oral and Maxillofacial Surgery in Mt. Kisco, NY

Active since June 09, 2009CLIA 33D2195889 · Waiver
105 SOUTH BEDFORD ROAD, SUITE 330, MT. KISCO, NY 10549(914) 242-1142(914) 242-1147 Get Directions Write a Review

NPPES record last updated: February 8, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South Bedford Oral & Maxillofacial Surgery Pllc NPPES

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

SOUTH BEDFORD ORAL & MAXILLOFACIAL SURGERY PLLC (NPI 1275769929) is a healthcare organization registered as an oral and maxillofacial surgery in Mt. Kisco, New York and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through October 12, 2026 and lists Jason Baker, Owner, as its authorized official.

NPPES Registry Identity

NPI1275769929
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameSOUTH BEDFORD ORAL & MAXILLOFACIAL SURGERY PLLC
Location Address105 SOUTH BEDFORD ROAD, SUITE 330Mt. Kisco, NY 10549-3466
Mailing Address105 South Bedford Road, Suite 330Mt. Kisco, NY 10549-3466 · (914) 242-1142 · Fax (914) 242-1147
Phone(914) 242-1142
Fax(914) 242-1147
Organization SubpartNo
Authorized OfficialJason BakerOwner · (914) 242-1142
Enumeration DateJune 9, 2009
Last NPPES UpdateFebruary 8, 2017
✔ NPI 1275769929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses✔ Licensed in NY · 051590✔ Licensed in NY · 052234✔ Licensed in NY · 049711
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.
105 SOUTH BEDFORD ROAD, Mt. Kisco, NY 10549
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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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2195889

Soth Bedford Oral & Maxfacial Surgery · Mount Kisco, NY
Active · expires Oct 12, 2026
CLIA Number33D2195889
Laboratory TypePhysician Office
Certificate Effective DateOctober 13, 2024
Certificate Expiration DateOctober 12, 2026
Laboratory DirectorDr. Jason Baker
Laboratory Phone(914) 242-1142
Laboratory LocationSoth Bedford Oral & Maxfacial Surgery105 South Bedford Road Suite 330, Mount Kisco, NY 10549
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

COMMUNITY LIVING CORPORATION
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
105 SOUTH BEDFORD ROAD
MOUNT KISCO, NY 10549
Westchester County (914) 241-3628

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 Bedford Oral & Maxillofacial Surgery PLLC's NPI number?

The NPI number for South Bedford Oral & Maxillofacial Surgery PLLC is 1275769929. It was assigned to this organization in the NPPES registry on June 9, 2009.

Where is South Bedford Oral & Maxillofacial Surgery PLLC located?

South Bedford Oral & Maxillofacial Surgery PLLC is located at 105 South Bedford Road Suite 330, Mt. Kisco, NY 10549. The listed phone number is (914) 242-1142.

What is South Bedford Oral & Maxillofacial Surgery PLLC's specialty?

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

Does South Bedford Oral & Maxillofacial Surgery PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2195889) is associated with this NPI, valid through October 12, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does South Bedford Oral & Maxillofacial Surgery PLLC accept?

Health plans from UnitedHealthcare list South Bedford Oral & Maxillofacial Surgery PLLC 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 South Bedford Oral & Maxillofacial Surgery PLLC was last updated on February 8, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.