SHEBOYGAN ORAL AND MAXILLOFACIAL ASSOC LTD
NPI 1306894134
Dentist - Oral and Maxillofacial Surgery in Sheboygan, WI

Q: What is Sheboygan Oral And Maxillofacial Assoc Ltd's specialty?

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

Active since May 04, 2006

.3637 WILGUS AVENUE, SHEBOYGAN, WI 53081(920) 458-8213(920) 459-9797 Get Directions Write a Review

NPPES record last updated: January 21, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Sheboygan Oral And Maxillofacial Assoc Ltd NPPES

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

SHEBOYGAN ORAL AND MAXILLOFACIAL ASSOC LTD (NPI 1306894134) is a healthcare organization registered as an oral and maxillofacial surgery in Sheboygan, Wisconsin and active in the NPI registry since May 2006. The organization lists John Jay Keller, President, as its authorized official.

NPPES Registry Identity

NPI1306894134

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameSHEBOYGAN ORAL AND MAXILLOFACIAL ASSOC LTD

Location Address.3637 WILGUS AVENUESheboygan, WI 53081

Mailing Address3637 Wilgus AvenueSheboygan, WI 53081 · (920) 458-8213 · Fax (920) 459-9797

Phone(920) 458-8213

Fax(920) 459-9797

Organization SubpartNo

Authorized OfficialJohn Jay KellerPresident · (920) 458-8213

Enumeration DateMay 4, 2006

Last NPPES UpdateJanuary 21, 2009

✔ NPI 1306894134 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.

.3637 WILGUS AVENUE, Sheboygan, WI 53081

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Other Identifiers 2

Medicare PIN000079744WI

Medicaid38365300WI

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

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 Sheboygan Oral And Maxillofacial Assoc Ltd's NPI number?

The NPI number for Sheboygan Oral And Maxillofacial Assoc Ltd is 1306894134. It was assigned to this organization in the NPPES registry on May 4, 2006.

Where is Sheboygan Oral And Maxillofacial Assoc Ltd located?

Sheboygan Oral And Maxillofacial Assoc Ltd is located at .3637 Wilgus Avenue, Sheboygan, WI 53081. The listed phone number is (920) 458-8213.

What is Sheboygan Oral And Maxillofacial Assoc Ltd'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 Sheboygan Oral And Maxillofacial Assoc Ltd was last updated on January 21, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.