Blue Ridge Oral & Maxillofacial Surgery
LBN: Blue Ridge Oral Surgery, Inc.
Blue Ridge Oral & Maxillofacial Surgery is an health care organization with primary practice located at 54 S. Medical Park Drive , Fishersville VA 22939-2333. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty.
Blue Ridge Oral Surgery, Inc. can be contacted via phone (540) 886-2956, or through Brandt, Matthew Todd via phone (540) 886-2956.
Contact Information
Primary practice address
54 S. Medical Park Drive
Fishersville VA 22939-2333
Phone: (540) 886-2956
Fax: (540) 886-2284
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 0438000074 | Virginia |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 0438000220 | Virginia |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 0401410707 | Virginia |
Profile Details
| NPI number | 1710013446 |
|---|---|
| LBN Legal business name | Blue Ridge Oral Surgery, Inc. |
| DBA Doing business as | Blue Ridge Oral & Maxillofacial Surgery |
| Authorized official | Brandt, Matthew Todd D.D.S., M.D. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Jul 10th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710013446 | NPPES |
| Other | 11605304 | CAQH | |
| MEDICAID | 9198564 | CAQH |
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