UPSTATE ORAL & MAXILLOFACIAL SURGERY & DENTAL IMPLANT CENTER, P.A.
NPI 1770707887
Dentist - Oral and Maxillofacial Surgery in Easley, SC

Q: What is Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.A.'s specialty?

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

Active since April 12, 2007

227 S PENDLETON ST, SUITE A, EASLEY, SC 29640(864) 855-0383(864) 855-0390 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.a. NPPES

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

UPSTATE ORAL & MAXILLOFACIAL SURGERY & DENTAL IMPLANT CENTER, P.A. (NPI 1770707887) is a healthcare organization registered as an oral and maxillofacial surgery in Easley, South Carolina and active in the NPI registry since April 2007. The organization lists Samer Atallah Joudeh, Owner, as its authorized official.

NPPES Registry Identity

NPI1770707887

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameUPSTATE ORAL & MAXILLOFACIAL SURGERY & DENTAL IMPLANT CENTER, P.A.

Location Address227 S PENDLETON ST, SUITE AEasley, SC 29640-3047

Mailing Address227 S Pendleton St, Suite AEasley, SC 29640-3047 · (864) 855-0383 · Fax (864) 855-0390

Phone(864) 855-0383

Fax(864) 855-0390

Organization SubpartNo

Authorized OfficialSamer Atallah JoudehOwner · (864) 855-0383

Enumeration DateApril 12, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1770707887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

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.

227 S PENDLETON ST, Easley, SC 29640

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Other Identifiers 6

MedicaidZZ1503SC

Other1780769307SC · Npi S. Anthony Bowie

Other1629182506SC · Npi W. Michael Riddle

Other1730197641SC · Npi Samer A. Joudeh

MedicaidZX3518SC

MedicaidZG1698SC

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 6

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

MARY ANN KETTERMAN

Physical Therapist

227 S PENDLETON ST, SUITE B
EASLEY, SC 29640

Pickens County (864) 855-7030

JEFFREY LANIER SPELL PT, ATC

Physical Therapist

227 S PENDLETON ST, STE B
EASLEY, SC 29640

Pickens County (864) 855-7030

DOSHER PHYSICAL THERAPY ASSOCIATES INC

Physical Therapist

227 S PENDLETON ST, STE B
EASLEY, SC 29640

Pickens County (864) 855-7030

MYLES FREDERICK BRYAN

Physical Therapy Assistant

227 S PENDLETON ST
EASLEY, SC 29640

Pickens County (864) 855-7030

ALEXANDRA HILL PT

Physical Therapist

227 S PENDLETON ST, SUITE B
EASLEY, SC 29640

Pickens County (864) 855-7030

MICHAEL L DOSHER PT

Physical Therapist

227 S PENDLETON ST, STE. B
EASLEY, SC 29640

Pickens County (864) 855-7030

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 Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.A.'s NPI number?

The NPI number for Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.A. is 1770707887. It was assigned to this organization in the NPPES registry on April 12, 2007.

Where is Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.A. located?

Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.A. is located at 227 S Pendleton St Suite A, Easley, SC 29640. The listed phone number is (864) 855-0383.

What is Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.A.'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 Upstate Oral & Maxillofacial Surgery & Dental Implant Center, P.A. 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.