WISDOM TEETH AND BEYOND ORAL SURGERY – NPI #1891641148
Clinic/Center

The specialty of dentistry which includes 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.

Health Care Provider Taxonomy Code for Clinic/Center

WISDOM TEETH AND BEYOND ORAL SURGERY is an AHC clinic located in HAINESVILLE, IL. NPPES recently assigned the NPI number 1891641148 to WISDOM TEETH AND BEYOND ORAL SURGERY on March 09, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QS0112X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Oral and Maxillofacial Surgery

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WISDOM TEETH AND BEYOND ORAL SURGERY below.

NPI Profile for
WISDOM TEETH AND BEYOND ORAL SURGERY

NPI Number
1891641148
Enumeration Date

(about 3 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WISDOM TEETH AND BEYOND ORAL SURGERY
Primary location
4 N DEER POINT RD STE 1008
HAINESVILLE, IL 60030-3814
Phone: (847) 388-6098 Fax: (847) 388-6099
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
ALEJANDRO VALLADARES
OWNER
Phone: (978) 855-6659
Updated
Certification Date
Mar 09, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QS0112X
- Clinic/Center / Oral and Maxillofacial Surgery (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.