Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northeast Oral and Maxillofacial Surgery

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1790860153

Northeast Oral and Maxillofacial Surgery is an Oral and Maxillofacial Surgery (Dentist) in Gahanna, Ohio. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

463 Waterbury Ct Ste A
Gahanna, OH 43230
Phone: (614) 471-6600
Fax: (614) 471-6660
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1790860153
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bruce Fraser — Owner · (614) 471-6600
NPI enumeratedOctober 26, 2006
Last updated in NPPESAugust 22, 2020
Mailing address463 Waterbury Court, Suite A, Gahanna, OH 43230

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