SOUTH CENTRAL ORAL & MAXILLOFACIAL SURGERY, LLC
NPI 1760461339
Dentist - Oral and Maxillofacial Surgery in Bloomington, IN

Q: What is South Central Oral & Maxillofacial 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 January 12, 2006

2911 E COVENANTER DR, SUITE B, BLOOMINGTON, IN 47401(812) 333-2614(812) 333-4594 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About South Central Oral & Maxillofacial Surgery, Llc NPPES

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

SOUTH CENTRAL ORAL & MAXILLOFACIAL SURGERY, LLC (NPI 1760461339) is a healthcare organization registered as an oral and maxillofacial surgery in Bloomington, Indiana and active in the NPI registry since January 2006. The organization lists Timothy A Pliske, Owner, as its authorized official.

NPPES Registry Identity

NPI1760461339

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameSOUTH CENTRAL ORAL & MAXILLOFACIAL SURGERY, LLC

Location Address2911 E COVENANTER DR, SUITE BBloomington, IN 47401-6320

Mailing Address2911 E Covenanter Dr, Suite BBloomington, IN 47401-6320 · (812) 333-2614 · Fax (812) 333-4594

Phone(812) 333-2614

Fax(812) 333-4594

Organization SubpartNo

Authorized OfficialTimothy A PliskeOwner · (812) 333-2614

Enumeration DateJanuary 12, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1760461339 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 IN · 12008000/12009582

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.

2911 E COVENANTER DR, Bloomington, IN 47401

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

South Central Oral & Maxillofacial Surgery, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to South Central Oral & Maxillofacial Surgery, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Timothy Pliske, D.D.S.

Maxillofacial Surgery

NPI 1134206618

2911 E COVENANTER DR SUITE B
Bloomington, IN 47401

(812) 333-2614

✔ PECOSSame address

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 South Central Oral & Maxillofacial Surgery, LLC's NPI number?

The NPI number for South Central Oral & Maxillofacial Surgery, LLC is 1760461339. It was assigned to this organization in the NPPES registry on January 12, 2006.

Where is South Central Oral & Maxillofacial Surgery, LLC located?

South Central Oral & Maxillofacial Surgery, LLC is located at 2911 E Covenanter Dr Suite B, Bloomington, IN 47401. The listed phone number is (812) 333-2614.

What is South Central Oral & Maxillofacial Surgery, LLC's specialty?

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

Is South Central Oral & Maxillofacial Surgery, LLC enrolled in Medicare?

Yes. South Central Oral & Maxillofacial Surgery, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through South Central Oral & Maxillofacial Surgery, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Maxillofacial Surgery) reassigns their Medicare billing to South Central Oral & Maxillofacial Surgery, LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does South Central Oral & Maxillofacial Surgery, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list South Central Oral & Maxillofacial Surgery, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Central Oral & Maxillofacial Surgery, LLC 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 6 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.