Provider Demographics
NPI:1518078435
Name:ORAL SURGERY GROUP INC.
Entity Type:Organization
Organization Name:ORAL SURGERY GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARUNAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:TAURAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:219-757-5700
Mailing Address - Street 1:8691 CONNECTICUT ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6222
Mailing Address - Country:US
Mailing Address - Phone:219-757-5700
Mailing Address - Fax:219-757-5706
Practice Address - Street 1:8691 CONNECTICUT ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6222
Practice Address - Country:US
Practice Address - Phone:219-757-5700
Practice Address - Fax:219-757-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN78551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN385080Medicare ID - Type Unspecified
INT34732Medicare UPIN