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INNOVATIVE IMPLANT & ORAL SURGERY PC
NPI 1679547707
Oral & Maxillofacial Surgery in Feasterville Trevose, PA

Active since February 15, 2006
1300 BRIDGETOWN PIKE, FEASTERVILLE TREVOSE, PA 19053(215) 322-7810(215) 322-7832 Get Directions Write a Review

NPPES record last updated: January 23, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 23, 2026, Jan 10, 2023, Sep 6, 2019 and 1 more (4 updates tracked since 2019).

About Innovative Implant & Oral Surgery Pc NPPES

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

INNOVATIVE IMPLANT & ORAL SURGERY PC (NPI 1679547707), doing business as Charles B Nissman Dds, is a healthcare organization registered as an oral & maxillofacial surgery in Feasterville Trevose, Pennsylvania and active in the NPI registry since February 2006. The organization maintains 2 additional practice locations and lists Debra Robyn Lodise, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1679547707
Entity TypeOrganization
Primary Taxonomy204E00000X
Legal Business NameINNOVATIVE IMPLANT & ORAL SURGERY PC
Location Address1300 BRIDGETOWN PIKEFeasterville Trevose, PA 19053-4326
Mailing Address1300 Bridgetown PikeFeasterville Trevose, PA 19053-4326 · (215) 322-7810 · Fax (215) 322-7832
Phone(215) 322-7810
Fax(215) 322-7832
Organization SubpartNo
Authorized OfficialDebra Robyn LodiseOffice Manager · (215) 322-7810
Enumeration DateFebruary 15, 2006
Last NPPES UpdateJanuary 23, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 23, 2026
✔ NPI 1679547707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
Definition
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.
Also ListedDurable Medical Equipment & Medical Supplies · Customized EquipmentTaxonomy 332BC3200X
1300 BRIDGETOWN PIKE, Feasterville Trevose, PA 19053
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Other Names 2

Former Legal Business NameCharles B Nissman Dds
Former Legal Business NameNissman-salin Oral & Maxillofacial Surgery Pc

Secondary Practice Locations 2

Location 11494 Old York Rd Fl 2Abington, PA 19001-2614 · Phone (215) 322-7810 · Fax (215) 322-7832
Location 2638 Newtown Yardley Rd Ste 2ANewtown, PA 18940-1739 · Phone (215) 322-7810 · Fax (215) 322-7832

Other Identifiers 5

Other1615888PA · Salin Blue Shield
Other0547613000PA · Keyst Group#
Other4437PA · Aetna Nissman
Other161558PA · Nissman Blue Shield
Other747908PA · Blue Shield Group#

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Innovative Implant & Oral Surgery Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Innovative Implant & Oral Surgery PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Adam Semanoff, D.M.D.
Oral Surgery
NPI 1639419369
1300 BRIDGETOWN PIKE
Feasterville Trevose, PA 19053
(215) 322-7810
✔ PECOS✔ Accepts MedicareSame address
Maciej Kosakowski, DMD
Oral Surgery
NPI 1467085498
1300 BRIDGETOWN PIKE
Feasterville Trevose, PA 19053
(215) 322-7810
✔ PECOS✔ Accepts MedicareSame address
Jared Weiner, DMD
Oral Surgery
NPI 1598003121
1300 BRIDGETOWN PIKE
Feasterville, PA 19053
(215) 322-7810
✔ PECOS✔ Accepts MedicareSame address
Charles Nissman, DDS
Oral Surgery
NPI 1538133665
137 W STREET RD
Feasterville, PA 19053
(215) 322-7810
✔ PECOS0.4 mi
Michael Salin, DMD
Oral Surgery
NPI 1881668929
137 W STREET RD
Feasterville, PA 19053
(215) 322-7810
✔ PECOS✔ Accepts Medicare0.4 mi
Bryan Nack, D.M.D.
Oral Surgery
NPI 1073966545
609 HARPER AVE
Jenkintown, PA 19046
(267) 736-6400
✔ PECOS✔ Accepts Medicare8.0 mi
Jordan Fried, D.M.D.
Oral Surgery
NPI 1932487675
166 BUNN DR STE 103
Princeton, NJ 08540
(609) 924-1621
✔ PECOS23 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Innovative Implant & Oral Surgery PC's NPI number?

The NPI number for Innovative Implant & Oral Surgery PC is 1679547707. It was assigned to this organization in the NPPES registry on February 15, 2006. The provider was formerly known as Charles B Nissman DDS and Nissman-Salin Oral & Maxillofacial Surgery PC.

Where is Innovative Implant & Oral Surgery PC located?

Innovative Implant & Oral Surgery PC is located at 1300 Bridgetown Pike, Feasterville Trevose, PA 19053. The listed phone number is (215) 322-7810.

What is Innovative Implant & Oral Surgery PC's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Innovative Implant & Oral Surgery PC enrolled in Medicare?

Yes. Innovative Implant & Oral Surgery PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Innovative Implant & Oral Surgery PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Oral Surgery, reassign their Medicare billing to Innovative Implant & Oral Surgery PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Innovative Implant & Oral Surgery PC was last updated on January 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.