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

Providence Oral Surgery and Dental Implant Center

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1912468463

Providence Oral Surgery and Dental Implant Center is an Oral and Maxillofacial Surgery (Dentist) in Waxhaw, North Carolina. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2

Practice location Address checks out

102 Waxhaw Professional Park Dr Ste G
Waxhaw, NC 28173-5024
Phone: (732) 547-9101
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
Oral and Maxillofacial Surgery Clinic/Center Taxonomy 261QS0112X

Record details

NPI number1912468463
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Parelli — Oral Surgeon/Owner · (704) 289-8819
NPI enumeratedMarch 27, 2019
Last updated in NPPESOctober 26, 2021
Certification dateOctober 26, 2021
Mailing address102 Waxhaw Professional Park Dr Ste G, Waxhaw, NC 28173-5024

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