BLOOMINGTON ORAL & MAXILLOFACIAL SURGERY GROUP
NPI 1386762318
Oral & Maxillofacial Surgery in Bloomington, IN
- Organization
- Oral & Maxillofacial Surgery
About BLOOMINGTON ORAL & MAXILLOFACIAL SURGERY GROUP
This page provides the complete NPI Profile along with additional information for Bloomington Oral & Maxillofacial Surgery Group, a provider established in Bloomington, Indiana operating as a Oral & Maxillofacial Surgery. The healthcare provider is registered in the NPI registry with number 1386762318 assigned on March 2007. The practitioner's primary taxonomy code is 204E00000X with license number IN12010196A (IN). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Scott E Tate Dds Ms (Doctor President)
- NPI
- 1386762318 Verify this NPI
- Provider Name
- BLOOMINGTON ORAL & MAXILLOFACIAL SURGERY GROUP
- Entity Type
- Organization
- Location Address
- 637 S WALKER STREET SUITE 1 BLOOMINGTON, IN 47403
- Location Phone
- (812) 323-9700
- Location Fax
- (812) 323-9701
- Mailing Address
- 637 S WALKER STREET SUITE 1 BLOOMINGTON, IN 47403
- Mailing Phone
- (812) 323-9700
- Mailing Fax
- (812) 323-9701
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-27-2007
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Oral & Maxillofacial Surgery
- Taxonomy Code
- 204E00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- IN12010196A
- License State
- IN
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386762318, enumerated as an "organization" on March 27, 2007.
The provider is located at 637 S WALKER STREET SUITE 1 BLOOMINGTON, IN 47403 and the phone number is (812) 323-9700.
Oral & Maxillofacial Surgery with taxonomy code 204E00000X.
