| Blue Ridge Oral Surgery, Inc. | |
|
54 S. Medical Park Drive Fishersville VA 22939-2333 | |
| (540) 886-2956 | |
| (540) 886-2284 |
| Full Name | Blue Ridge Oral Surgery, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 54 S. Medical Park Drive, Fishersville, Virginia |
| Authorized Official Name and Position | Matthew Todd Brandt (PRESIDENT) |
| Authorized Official Contact | 5408862956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Ridge Oral Surgery, Inc. 54 S. Medical Park Drive Fishersville VA 22939-2333 Ph: (540) 886-2956 | Blue Ridge Oral Surgery, Inc. 54 S. Medical Park Drive Fishersville VA 22939-2333 Ph: (540) 886-2956 |
| NPI Number | 1710013446 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 07/10/2013 |
| Medicare PECOS PAC ID | 5496827834 |
|---|---|
| Medicare Enrollment ID | O20080701000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710013446 | NPI | - | NPPES |
| 11605304 | Other | CAQH | |
| 9198564 | Medicaid | VA |
| Provider Name | Matthew Todd Brandt |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1942308259 PECOS PAC ID: 2769554104 Enrollment ID: I20080701000051 |
| Provider Name | Corey Christina Burgoyne |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1518174614 PECOS PAC ID: 0345314811 Enrollment ID: I20080731000466 |
| Provider Name | Samuel E Scroggins |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1487742375 PECOS PAC ID: 7214179225 Enrollment ID: I20130803000169 |
| Provider Name | Kaitlin Shea Roadcap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346946779 PECOS PAC ID: 0446785075 Enrollment ID: I20241120000020 |
Mark A Hammock Dds Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 49 Tinkling Spring Road, Fishersville, VA 22939 Phone: 540-942-9013 | |
Augusta Regional Dental Clinic Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 342 Mule Academy Rd, Fishersville, VA 22939 Phone: 540-332-5619 Fax: 540-332-5622 | |
Bradford & Catchings Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Briar Knoll Ct, Suite 5, Fishersville, VA 22939 Phone: 540-213-1966 Fax: 540-213-1968 | |
Daniel J Bartling Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9 Pinnacle Dr Ste 101, Fishersville, VA 22939 Phone: 540-886-0531 | |
James W Willis Ii Dds Plc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 41 S Medical Park Dr Ste 100, Fishersville, VA 22939 Phone: 540-885-8037 |