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

Shore Oral Maxillo Surgery Group PA

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1619104015

Shore Oral Maxillo Surgery Group PA is an Oral and Maxillofacial Surgery (Dentist) in Lakewood, New Jersey. Licensed in New Jersey. Registered with an NPI since 2009.

Licensed in
NJ
In the registry since
2009
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

301 Madison Ave
Lakewood, NJ 08701-3266
Phone: (732) 367-4042
Fax: (732) 905-9210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence DI09103 (NJ)

Record details

NPI number1619104015
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Gaines — Ower · (732) 367-4042
NPI enumeratedJune 12, 2009
Last updated in NPPESJune 12, 2009
Mailing address301 Madison Ave, Lakewood, NJ 08701-3266

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