THIRD COAST ORAL & MAXILLOFACIAL SURGERY
NPI 1902551351
Clinic/Center - Oral and Maxillofacial Surgery in Byron Center, MI

Active since February 15, 2022CLIA 23D2307802 · Waiver
2119 64TH ST SW, BYRON CENTER, MI 49315(616) 217-3632(616) 217-3634 Get Directions Write a Review

NPPES record last updated: February 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Third Coast Oral & Maxillofacial Surgery NPPES

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

THIRD COAST ORAL & MAXILLOFACIAL SURGERY (NPI 1902551351) is a healthcare organization registered as an oral and maxillofacial surgery in Byron Center, Michigan and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through July 15, 2028 and lists Annika Schott, Financial Coordinator, as its authorized official.

NPPES Registry Identity

NPI1902551351
Entity TypeOrganization
Primary Taxonomy261QS0112X
Legal Business NameTHIRD COAST ORAL & MAXILLOFACIAL SURGERY
Location Address2119 64TH ST SWByron Center, MI 49315-9409
Mailing Address2119 64th St SwByron Center, MI 49315-9409 · (616) 217-3632 · Fax (616) 217-3634
Fax(616) 217-3634
Organization SubpartNo
Authorized OfficialAnnika SchottFinancial Coordinator · (616) 583-7307
Enumeration DateFebruary 15, 2022
NPPES CertifiedFebruary 15, 2022
NPI 1902551351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Oral and Maxillofacial SurgeryAmbulatory Health Care Facilities
Taxonomy Code261QS0112X
Definition
An oral and maxillofacial surgery clinic or center 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.
2119 64TH ST SW, Byron Center, MI 49315

Other Identifiers 2

Other1811378508MI · Nppes
Other1811378508MI · Npi

Accepted 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 23D2307802

Third Coast Oral & Maxillofacial Surgery · Byron Center, MI
Active · expires Jul 15, 2028
CLIA Number23D2307802
Laboratory TypeIndependent
Certificate Effective DateJuly 16, 2026
Certificate Expiration DateJuly 15, 2028
Laboratory DirectorChristopher C. Niquette
Laboratory Phone(616) 217-3632
Laboratory LocationThird Coast Oral & Maxillofacial Surgery2119 64th Street SW, Byron Center, MI 49315
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Nurse Practitioner (Family)
2119 64TH ST SW
BYRON CENTER, MI 49315
Dentist (Oral and Maxillofacial Surgery)
2119 64TH ST SW
BYRON CENTER, MI 49315

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 Third Coast Oral & Maxillofacial Surgery's NPI number?

The NPI number for Third Coast Oral & Maxillofacial Surgery is 1902551351. It was assigned to this organization in the NPPES registry on February 15, 2022.

Where is Third Coast Oral & Maxillofacial Surgery located?

Third Coast Oral & Maxillofacial Surgery is located at 2119 64th St SW, Byron Center, MI 49315. The listed phone number is (616) 217-3632.

What is Third Coast Oral & Maxillofacial Surgery's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Oral and Maxillofacial Surgery, with taxonomy code 261QS0112X.

Does Third Coast Oral & Maxillofacial Surgery hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2307802) is associated with this NPI, valid through July 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Third Coast Oral & Maxillofacial Surgery accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Third Coast Oral & Maxillofacial Surgery 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 Third Coast Oral & Maxillofacial Surgery was last updated on February 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.