NORTHEAST ORAL AND MAXILLOFACIAL SURGERY
NPI 1790860153
Dentist - Oral and Maxillofacial Surgery in Gahanna, OH

Q: What is Northeast Oral And Maxillofacial Surgery's specialty?

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

Active since October 26, 2006

463 WATERBURY COURT, SUITE A, GAHANNA, OH 43230(614) 471-6600(614) 471-6660 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Northeast Oral And Maxillofacial Surgery NPPES

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

NORTHEAST ORAL AND MAXILLOFACIAL SURGERY (NPI 1790860153) is a healthcare organization registered as an oral and maxillofacial surgery in Gahanna, Ohio and active in the NPI registry since October 2006. The organization lists Bruce Allen Fraser, Owner, as its authorized official.

NPPES Registry Identity

NPI1790860153

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameNORTHEAST ORAL AND MAXILLOFACIAL SURGERY

Location Address463 WATERBURY COURT, SUITE AGahanna, OH 43230

Mailing Address463 Waterbury Court, Suite AGahanna, OH 43230 · (614) 471-6600 · Fax (614) 471-6660

Phone(614) 471-6600

Fax(614) 471-6660

Organization SubpartNo

Authorized OfficialBruce Allen FraserOwner · (614) 471-6600

Enumeration DateOctober 26, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1790860153 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.

463 WATERBURY COURT, Gahanna, OH 43230

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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

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 Northeast Oral And Maxillofacial Surgery's NPI number?

The NPI number for Northeast Oral And Maxillofacial Surgery is 1790860153. It was assigned to this organization in the NPPES registry on October 26, 2006.

Where is Northeast Oral And Maxillofacial Surgery located?

Northeast Oral And Maxillofacial Surgery is located at 463 Waterbury Court Suite A, Gahanna, OH 43230. The listed phone number is (614) 471-6600.

What is Northeast Oral And Maxillofacial Surgery'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 Northeast Oral And Maxillofacial Surgery 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.