BI-STATE ORAL AND FACIAL SURGERY, LLC
NPI 1669824439
Dentist - Oral and Maxillofacial Surgery in Alton, IL

Q: What is Bi-State Oral And Facial Surgery, LLC's specialty?

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

Active since July 06, 2016

3555 COLLEGE AVE, ALTON, IL 62002(618) 462-1646(618) 462-5721 Get Directions Write a Review

NPPES record last updated: October 26, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Bi-state Oral And Facial Surgery, Llc NPPES

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

BI-STATE ORAL AND FACIAL SURGERY, LLC (NPI 1669824439) is a healthcare organization registered as an oral and maxillofacial surgery in Alton, Illinois and active in the NPI registry since July 2016. The organization lists Benjamin Jacob Schlott, Single Member, as its authorized official.

NPPES Registry Identity

NPI1669824439

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameBI-STATE ORAL AND FACIAL SURGERY, LLC

Location Address3555 COLLEGE AVEAlton, IL 62002-5009

Mailing Address3555 College AveAlton, IL 62002-5009 · (618) 462-1646 · Fax (618) 462-5721

Phone(618) 462-1646

Fax(618) 462-5721

Organization SubpartNo

Authorized OfficialBenjamin Jacob SchlottSingle Member · (618) 462-1646

Enumeration DateJuly 6, 2016

Last NPPES UpdateOctober 26, 2022

NPPES CertifiedOctober 26, 2022

✔ NPI 1669824439 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 IL · 021002736

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.

3555 COLLEGE AVE, Alton, IL 62002

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Other Identifiers 1

Medicaid1891938296MO

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

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

DR. BENJAMIN JACOB SCHLOTT D.M.D , M.D.

Dentist (Oral and Maxillofacial Surgery)

3555 COLLEGE AVE
ALTON, IL 62002

Madison County (618) 462-1646

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 Bi-State Oral And Facial Surgery, LLC's NPI number?

The NPI number for Bi-State Oral And Facial Surgery, LLC is 1669824439. It was assigned to this organization in the NPPES registry on July 6, 2016.

Where is Bi-State Oral And Facial Surgery, LLC located?

Bi-State Oral And Facial Surgery, LLC is located at 3555 College Ave, Alton, IL 62002. The listed phone number is (618) 462-1646.

What is Bi-State Oral And Facial Surgery, LLC'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 Bi-State Oral And Facial Surgery, LLC was last updated on October 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.