SHORE ORAL MAXILLO SURGERY GROUP PA
NPI 1619104015
Dentist - Oral and Maxillofacial Surgery in Lakewood, NJ

Active since June 12, 2009
301 MADISON AVE, LAKEWOOD, NJ 08701(732) 367-4042(732) 905-9210 Get Directions Write a Review

NPPES record last updated: June 12, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Shore Oral Maxillo Surgery Group Pa NPPES

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

SHORE ORAL MAXILLO SURGERY GROUP PA (NPI 1619104015) is a healthcare organization registered as an oral and maxillofacial surgery in Lakewood, New Jersey and active in the NPI registry since June 2009. The organization lists Richard L Gaines, Ower, as its authorized official.

NPPES Registry Identity

NPI1619104015
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameSHORE ORAL MAXILLO SURGERY GROUP PA
Location Address301 MADISON AVELakewood, NJ 08701-3266
Mailing Address301 Madison AveLakewood, NJ 08701-3266 · (732) 367-4042 · Fax (732) 905-9210
Fax(732) 905-9210
Organization SubpartNo
Authorized OfficialRichard L GainesOwer · (732) 367-4042
Enumeration DateJune 12, 2009
NPI 1619104015 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 NJ · DI09103
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.

301 MADISON AVE, Lakewood, NJ 08701

Other Identifiers 1

Medicaid1642006NJ

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 14

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

Dentist (General Practice)
301 MADISON AVE
LAKEWOOD, NJ 08701
Speech-Language Pathologist
301 MADISON AVE
LAKEWOOD, NJ 08701
Pharmacy (Community/Retail Pharmacy)
301 MADISON AVE, STE 7
LAKEWOOD, NJ 08701
Dentist (General Practice)
301 MADISON AVE
LAKEWOOD, NJ 08701
Dentist (Orthodontics and Dentofacial Orthopedics)
301 MADISON AVE
LAKEWOOD, NJ 08701
Pharmacist
301 MADISON AVE, SUITE 7
LAKEWOOD, NJ 08701
Dentist (General Practice)
301 MADISON AVE
LAKEWOOD, NJ 08701
Dentist (Oral and Maxillofacial Surgery)
301 MADISON AVE
LAKEWOOD, NJ 08701

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 Shore Oral Maxillo Surgery Group PA's NPI number?

The NPI number for Shore Oral Maxillo Surgery Group PA is 1619104015. It was assigned to this organization in the NPPES registry on June 12, 2009.

Where is Shore Oral Maxillo Surgery Group PA located?

Shore Oral Maxillo Surgery Group PA is located at 301 Madison Ave, Lakewood, NJ 08701. The listed phone number is (732) 367-4042.

What is Shore Oral Maxillo Surgery Group 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 Shore Oral Maxillo Surgery Group PA was last updated on June 12, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.