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TALLAHASSEE ORAL AND MAXILLOFACIAL SURGERY, PLLC
NPI 1902398639
Dentist - Oral and Maxillofacial Surgery in Tallahassee, FL

Active since May 30, 2018CLIA 10D2148891 · Waiver
3665 COOLIDGE CT STE 102, TALLAHASSEE, FL 32311(850) 431-6725(850) 431-6859 Get Directions Write a Review

NPPES record last updated: June 4, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 4, 2021, Jan 5, 2021 (2 updates tracked since 2021).

About Tallahassee Oral And Maxillofacial Surgery, Pllc NPPES

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

TALLAHASSEE ORAL AND MAXILLOFACIAL SURGERY, PLLC (NPI 1902398639) is a healthcare organization registered as an oral and maxillofacial surgery in Tallahassee, Florida and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through May 20, 2028 and lists Ricardo Ortiz, Oral And Maxillofacial Surgeon, as its authorized official.

NPPES Registry Identity

NPI1902398639
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameTALLAHASSEE ORAL AND MAXILLOFACIAL SURGERY, PLLC
Location Address3665 COOLIDGE CT STE 102Tallahassee, FL 32311-7894
Mailing Address3665 Coolidge Ct Ste 102Tallahassee, FL 32311-7894 · (850) 431-6725 · Fax (850) 431-6859
Phone(850) 431-6725
Fax(850) 431-6859
Organization SubpartNo
Authorized OfficialRicardo OrtizOral And Maxillofacial Surgeon · (787) 556-6039
Enumeration DateMay 30, 2018
Last NPPES UpdateJune 4, 20212 updates tracked since enumeration
NPPES CertifiedJune 4, 2021
✔ NPI 1902398639 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.
3665 COOLIDGE CT STE 102, Tallahassee, FL 32311
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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 DentaQuest Insurance Company, Inc..Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2148891

Tallahassee Oral Maxillofacial Surgery · Tallahassee, FL
Active · expires May 20, 2028
CLIA Number10D2148891
Laboratory TypeOral Surgery Office
Certificate Effective DateMay 21, 2026
Certificate Expiration DateMay 20, 2028
Laboratory DirectorRicardo M. Ortiz
Laboratory Phone(850) 431-6725
Laboratory LocationTallahassee Oral Maxillofacial Surgery3665 Coolidge Court Suite 102, Tallahassee, FL 32311
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Tallahassee Oral And Maxillofacial Surgery, PLLC's NPI number?

The NPI number for Tallahassee Oral And Maxillofacial Surgery, PLLC is 1902398639. It was assigned to this organization in the NPPES registry on May 30, 2018.

Where is Tallahassee Oral And Maxillofacial Surgery, PLLC located?

Tallahassee Oral And Maxillofacial Surgery, PLLC is located at 3665 Coolidge Ct Ste 102, Tallahassee, FL 32311. The listed phone number is (850) 431-6725.

What is Tallahassee Oral And Maxillofacial Surgery, PLLC's specialty?

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

Does Tallahassee Oral And Maxillofacial Surgery, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2148891) is associated with this NPI, valid through May 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Tallahassee Oral And Maxillofacial Surgery, PLLC accept?

Health plans from DentaQuest Insurance Company, Inc. list Tallahassee Oral And Maxillofacial Surgery, PLLC 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 Tallahassee Oral And Maxillofacial Surgery, PLLC was last updated on June 4, 2021. 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.