BERKELEY ORAL AND MAXILLOFACIAL SURGERY PA
NPI 1558486845
Dentist - Oral and Maxillofacial Surgery in Bonneau, SC

Q: What is Berkeley Oral And Maxillofacial Surgery PA's specialty?

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

Active since March 19, 2007

111 SHELLY ST., BONNEAU, SC 29431(843) 825-4131(843) 825-4136 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Berkeley Oral And Maxillofacial Surgery Pa NPPES

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

BERKELEY ORAL AND MAXILLOFACIAL SURGERY PA (NPI 1558486845) is a healthcare organization registered as an oral and maxillofacial surgery in Bonneau, South Carolina and active in the NPI registry since March 2007. The organization lists James Albert Montgomery, Oral Surgeon, as its authorized official.

NPPES Registry Identity

NPI1558486845

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameBERKELEY ORAL AND MAXILLOFACIAL SURGERY PA

Location Address111 SHELLY ST.Bonneau, SC 29431-0280

Mailing AddressPo Box 280Bonneau, SC 29431-0280 · (843) 825-4131 · Fax (843) 825-4136

Phone(843) 825-4131

Fax(843) 825-4136

Organization SubpartNo

Authorized OfficialJames Albert MontgomeryOral Surgeon · (843) 825-4131

Enumeration DateMarch 19, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1558486845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in SC · 3180

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.

111 SHELLY ST., Bonneau, SC 29431

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Other Identifiers 1

Other1790759967SC · Individual Npi

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 NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Berkeley Oral And Maxillofacial Surgery PA's NPI number?

The NPI number for Berkeley Oral And Maxillofacial Surgery PA is 1558486845. It was assigned to this organization in the NPPES registry on March 19, 2007.

Where is Berkeley Oral And Maxillofacial Surgery PA located?

Berkeley Oral And Maxillofacial Surgery PA is located at 111 Shelly St., Bonneau, SC 29431. The listed phone number is (843) 825-4131.

What is Berkeley Oral And Maxillofacial Surgery PA'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 Berkeley Oral And Maxillofacial Surgery PA was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.