Overview
Legacy Oral and Facial Surgery Center PC is a Oral and Maxillofacial Surgery Clinic/Center (organization) practicing in Ann Arbor, Michigan. The National Provider Identifier (NPI) is #1841862232, which was assigned on July 14, 2021, and the registration record was last updated on July 14, 2021. The practitioner's main practice location is at 2521 Jackson Ave, Ann Arbor, MI 48103-3818; the contact telephone number is 7342100677, and the fax number is 7342101273. The primary taxonomy of Legacy Oral and Facial Surgery Center PC is Oral and Maxillofacial Surgery Clinic/Center (261QS0112X), with specialization in Oral and Maxillofacial Surgery. The authorized official for Legacy Oral and Facial Surgery Center PC is Dalbert W Fear Jr. (Owner).
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.
Provider Information
| NPI | 1841862232 |
| Entity Type | Organization |
| Organization Name | LEGACY ORAL AND FACIAL SURGERY CENTER PC |
| Provider Name | LEGACY ORAL AND FACIAL SURGERY CENTER PC |
| Practice Address | 2521 Jackson Ave Ann Arbor MI 48103-3818 |
| Practice Telephone | 7342100677 |
| Practice Fax Number | 7342101273 |
| Mailing Address | 3706 Creekside Ct Ann Arbor MI 48105-9570 |
| Mailing Telephone | 7343959532 |
| Mailing Fax Number | 7409195871 |
| Certification Date | 2021-07-14 |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-07-14 |
| Is Organization Subpart | N |
Authorized Official Information
| Official Name | DALBERT W FEAR JR. |
| Official Title | OWNER |
| Credential | DDS.,MS. |
| Telephone | 7343959532 |
Taxonomy and Licenses
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| Y | 261QS0112X | Clinic/Center | Oral and Maxillofacial Surgery |
Taxonomy Information
Primary Taxonomy
| Code | 261QS0112X |
| Taxonomy | Oral and Maxillofacial Surgery Clinic/Center |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| Grouping | Ambulatory Health Care Facilities |
| Definition: 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
Providers with the same taxonomy
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Perry B Young Dds Ltd | 601 W Moana Ln Ste 5, Reno, NV 89509-4959 | Oral and Maxillofacial Surgery Clinic/Center | 2023-08-21 |
| Oral Surgery Associates of Lebanon | 735 Norman Dr Ste A, Lebanon, PA 17042-7559 | Oral and Maxillofacial Surgery Clinic/Center | 2023-12-06 |
| Arian Chehrehsa Dds Inc | 935 Blanco Cir, Salinas, CA 93901-4446 | Oral and Maxillofacial Surgery Clinic/Center | 2024-03-21 |
| Colorado Oral and Facial Cosmetic Surgery, PLLC | 10535 Park Meadows Blvd Ste 250, Lone Tree, CO 80124-8401 | Oral and Maxillofacial Surgery Clinic/Center | 2023-11-21 |
| 400 Treemonte Dr Ste A, Orange City, FL 32763-7978 | Oral and Maxillofacial Surgery Clinic/Center | 2023-11-29 | |
| Freshest Smiles LLC | 436 Fort Washington Ave Apt 1b, New York, NY 10033-3533 | Oral and Maxillofacial Surgery Clinic/Center | 2023-09-22 |
| 3600 Park East Dr Apt 539, Beachwood, OH 44122-4358 | Oral and Maxillofacial Surgery Clinic/Center | 2024-04-26 | |
| Premium Smiles LLC | 1810 Harriet St, Elmont, NY 11003-4326 | Oral and Maxillofacial Surgery Clinic/Center | 2023-09-22 |
| Beyond Smiles LLC | 736 W 181st St Apt 1i, New York, NY 10033-0465 | Oral and Maxillofacial Surgery Clinic/Center | 2023-09-22 |
| Eric D. Hoverstad Dds PLLC II | 220 Springbrook Ave Ste 110, Clayton, NC 27520-5311 | Oral and Maxillofacial Surgery Clinic/Center | 2023-11-09 |
| Find all providers with the same taxonomy | |||
Location Information
| Street Address | 2521 JACKSON AVE |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48103-3818 |
| Country | US |
Providers in the same location
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Alena Marie Fear | 2521 Jackson Ave, Ann Arbor, MI 48103-3818 | Oral and Maxillofacial Surgery (Dentist) | 2015-04-20 |
Providers in the same zip code
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Christian Hoban | 2577 Jackson Ave, Ann Arbor, MI 48103-3818 | Physical Therapist | 2021-08-25 |
| Mast Shoes Inc | 2517 Jackson Ave, Ann Arbor, MI 48103-3818 | Durable Medical Equipment & Medical Supplies | 2007-04-03 |
| Jacque Schiavo | 2577 Jackson Ave, Ann Arbor, MI 48103-3818 | Athletic Trainer | 2016-04-05 |
| Svs Vision Inc | 2555 Jackson Ave, Ann Arbor, MI 48103-3818 | Optometrist | 2012-10-30 |
| Pearle Vision Inc · Pearle Vision #C6647 | 2555 Jackson Rd, Ann Arbor, MI 48103-3818 | Eyewear Supplier | 2009-12-24 |
| Jean Christenson | 2555 Jackson Ave, Ann Arbor, MI 48103-3818 | Optometrist | 2007-02-08 |
| Luxottica Retail North America Inc · Pearle Vision #C6647 | 2555 Jackson Rd, Ann Arbor, MI 48103-3818 | Eyewear Supplier | 2007-01-29 |
| Ann Arbor Ardent PLLC | 2517 Jackson Ave, Ann Arbor, MI 48103-3818 | Dental Clinic/Center | 2022-03-10 |
| 2531 Jackson Ave Ste 232, Ann Arbor, MI 48103-3818 | Clinical Social Worker | 2018-12-10 | |
| Kevin Decker | 2577 Jackson Ave, Ann Arbor, MI 48103-3818 | Physical Therapist | 2014-08-26 |
| Find all providers in the same zip code | |||
Providers in the same zip code
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Liberty Dentistry PLLC | 3443 W. Liberty Rd, Ann Arbor, MI 48103 | Dental Clinic/Center | 2022-03-25 |
| Patrick Dominic Didonato | 1795 W Stadium, Ann Arbor, MI 48103 | Dentist | 2017-06-12 |
| Delta Life Counseling Plc | 1900 W. Stadium, Section C Suite 2, Ann Arbor, MI 48103 | Counselor | 2021-08-30 |
| Joel Maier | 4350 Jackson Road, Suite 100, Ann Arbor, MI 48103 | Social Worker | 2021-06-27 |
| Rise - Resilient Inclusive Sexual Health Education and Therapy PLLC | 5905 Quebec Ave, Ann Arbor, MI 48103 | Clinical Social Worker | 2022-04-05 |
| Laura Thomas | 405 Little Lake Dr Ste A4, Ann Arbor, MI 48103 | Clinical Social Worker | 2021-12-09 |
| Ellen Anne Tobin · Ellen Anne Murphy | 1785 West Stadium Blvd Heron Ridge Associates, Suite #205, Ann Arbor, MI 48103 | Mental Health Counselor | 2018-04-15 |
| Jacob B Nienhuis | 4488 Jackson Rd Ste 7b, Ann Arbor, MI 48103 | Counseling Psychologist | 2018-05-02 |
| Katherine Louise Pantolin | Abbot Elementary, 2670 Sequoia Parkway, Ann Arbor, MI 48103 | Speech-Language Pathologist | 2022-12-19 |
| Crenna, PLLC | 450 Wagner Road, And Arbor, MI 48103 | General Practice Dentistry | 2022-12-20 |
| Find all providers in the same zip code | |||
Similar Providers
Providers with similar names
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| 1820 N Whitley Dr, Fruitland, ID 83619-2163 | Exclusive Provider Organization | 2008-04-29 | |
| 6200 N Durango Dr, Las Vegas, NV 89149-3916 | Dentist | 2017-04-10 | |
| Fangman Oral and Facial Surgery Professional LLC · Altitude Oral Maxillofacial Implant Center | 1440 Blake St Ste 100, Denver, CO 80202-1475 | Oral and Maxillofacial Surgery (Dentist) | 2015-01-28 |
| Treasure Valley Oral and Facial Surgery PLLC · Boise Oral and Facial Surgery | 1000 N. Curtis Rd, Suite 103, Boise, ID 83706 | Oral and Maxillofacial Surgery (Dentist) | 2012-04-20 |
| 620 W 32nd St, Joplin, MO 64804 | Endodontist | 2006-05-09 | |
| Wichita Falls Oral and Facial Surgery, PLLC · Texoma Facial and Oral Surgery | 2304 Midwestern Pkwy, Suite 102, Wichita Falls, TX 76308-2342 | Oral and Maxillofacial Surgery (Dentist) | 2015-05-29 |
| Platinum Facial Surgical Group · Woodlands Oral and Facial Surgery Center | 10857 Kuykendahl Rd Ste 150, The Woodlands, TX 77382-2777 | Oral and Maxillofacial Surgery (Dentist) | 2014-12-12 |
| Caloss Center for Facial Reconstruction PLLC · Aligned Oral and Facial Surgery | 1200 N State St Ste 130, Jackson, MS 39202-2027 | Oral and Maxillofacial Surgery Clinic/Center | 2021-10-18 |
| Facial Oral and Dental Implant Surgery Associates, Inc. | 3326 4th St Ste 2, Lewiston, ID 83501-4455 | Oral and Maxillofacial Surgery (Dentist) | 2008-11-10 |
| 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | Oral and Maxillofacial Surgery (Dentist) | 2017-12-08 |
Improve Information
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Dataset Information
This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
Dataset Details
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).
All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).
Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.
This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.
