DE OMILIA PLASTIC SURGERY PC – NPI #1164618435
Oral & Maxillofacial Surgery

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

DE OMILIA PLASTIC SURGERY PC is an oral & maxillofacial surgeon located in BASKING RIDGE, NJ. NPPES has assigned the NPI number 1164618435 to DE OMILIA PLASTIC SURGERY PC on September 20, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 204E00000X from the Health Care Provider Taxonomy code set, which is classified as Oral & Maxillofacial Surgery.

The NPI profile was previously updated about 18 years ago on Apr 03, 2008. 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 DE OMILIA PLASTIC SURGERY PC below.

NPI Profile for
DE OMILIA PLASTIC SURGERY PC

NPI Number
1164618435
Enumeration Date

(more than 18 years 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
DE OMILIA PLASTIC SURGERY PC
Primary location
96 SOUTH FINLEY AVE
BASKING RIDGE, NJ 07920
Phone: (908) 221-1136 Fax: (908) 221-0482
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DAVID EVDOKIMOW
OWNER
Phone: (908) 221-1136
Updated
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
204E00000X
- Oral & Maxillofacial Surgery (Primary)
NJ 25MA07315300
2082S0105X
- Plastic Surgery / Surgery of the Hand
NJ 25MA07315300
208200000X
- Plastic Surgery
NJ 25MA07315300

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.