| Coastal Oral Surgery Group, Llc | |
|
9 Hospital Dr Suite 6 Toms River NJ 08755-6425 | |
| (732) 286-1199 | |
| (732) 286-2303 |
| Full Name | Coastal Oral Surgery Group, Llc |
|---|---|
| Speciality | Dentist |
| Location | 9 Hospital Dr, Toms River, New Jersey |
| Authorized Official Name and Position | Sharlene Marple (ADMINISTRATOR) |
| Authorized Official Contact | 7322861199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Oral Surgery Group, Llc 9 Hospital Dr Suite 6 Toms River NJ 08755-6425 Ph: (732) 286-1199 | Coastal Oral Surgery Group, Llc 9 Hospital Dr Suite 6 Toms River NJ 08755-6425 Ph: (732) 286-1199 |
| NPI Number | 1790800423 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 03/06/2024 |
| Medicare PECOS PAC ID | 9133305196 |
|---|---|
| Medicare Enrollment ID | O20110510000071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790800423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Michael D Dipietro |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1417929407 PECOS PAC ID: 1658557616 Enrollment ID: I20110510000179 |
| Provider Name | Daniel Winston |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1073725594 PECOS PAC ID: 1759532849 Enrollment ID: I20121120000162 |
| Provider Name | Yoonchan Han |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1477782779 PECOS PAC ID: 9537453741 Enrollment ID: I20160811000719 |
| Provider Name | John Soliman |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1932429198 PECOS PAC ID: 4789952763 Enrollment ID: I20180605000486 |
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