Wk Oral and Maxillofacial Surgery Institute
NPI 1104584515ActiveOrganization· Dentist, Oral and Maxillofacial Surgery· Shreveport, LA
Dentist, Oral and Maxillofacial Surgery in Shreveport, Louisiana, registered in NPPES in December 2021. The authorized official on file is Mary Jane Ward, Senior Vp Finance. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104584515 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 2, 2021 |
| Last updated in NPPES | Mar 4, 2026 |
| Certified by provider | Mar 4, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Oral and Maxillofacial Surgery Primary | 1223S0112X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (LA) |
|---|
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