Provider Demographics
NPI:1316587652
Name:ORAL SURGERY ANESTHESIA ASSOCIATES LLC
Entity Type:Organization
Organization Name:ORAL SURGERY ANESTHESIA ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANFORD
Authorized Official - Middle Name:R
Authorized Official - Last Name:PLAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-242-6360
Mailing Address - Street 1:438 TARA TRL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4926
Mailing Address - Country:US
Mailing Address - Phone:404-242-6360
Mailing Address - Fax:404-549-2853
Practice Address - Street 1:5825 GLENRIDGE DRIVE
Practice Address - Street 2:BUILDING 3, SUITE 101, #123
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-242-6360
Practice Address - Fax:404-902-5716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TECHNICAL ANESTHESIA STRATEGIES AND SOLUTIONS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-15
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No1223D0004XDental ProvidersDentistDentist AnesthesiologistGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric AnesthesiologyGroup - Multi-Specialty