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Shore Oral Maxillo Surgery Group PA

Oral surgery practice in Lakewood, NJ

Registered specialistLicense # listed (NJ)

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Public-record details

Address
301 Madison Ave, Lakewood, NJ 08701
Phone
(732) 367-4042
Listed under
Oral & maxillofacial surgeons, Specialty practices
NPI
1619104015
NPI status
Active in the NPPES registry
Provider type
Organization (practice, clinic or company)
Registered specialty (self-reported taxonomy)
Oral and Maxillofacial Surgery (1223S0112X)
License number on NPI record
DI09103 (NJ)
Authorized official
Richard Gaines, DMD, Ower
NPI first issued
Jun 12, 2009
NPI record last updated
Jun 12, 2009

NPI 1619104015 is active in the federal NPPES registry (CMS) with Oral and Maxillofacial Surgery, an ADA-recognized dental specialty, as its primary taxonomy; license DI09103 (NJ) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-09-30.

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Oral and maxillofacial surgeons are trained in surgery of the mouth and jaws, including placing implants, extractions, bone grafts and sinus lifts, and in anesthesia. Dentists who are not specialists can also place implants; the specialty here is the one the provider registered as primary.

View NPI 1619104015 in the official registry ↗

Checking credentials: the specialty shown is the one this provider registered with the NPI system. Your state dental board's license lookup confirms the license, and the American Board of Prosthodontics, the American Board of Oral and Maxillofacial Surgery and the American Board of Periodontology each list their board-certified members.

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