AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD – Oral and Maxillofacial Surgery (Dentist), NPI 1215196290

AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD is a healthcare provider. based in Champaign, Illinois. specializing in Oral and Maxillofacial Surgery (Dentist). The organization holds a License No. 019021176 (IL). The NPI Number for AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD is 1215196290

Main info

Organization
Name
AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD
NPI
1215196290
Phone
(217) 351-7111
Address
3112 VILLAGE OFFICE PL
Authorized Official
DR. PHILIP R. BANGHART PRESIDENT/ORAL SURGEON DDS
Enumeration Date
5 June 2008
Last Update Date
5 June 2008
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD

  • Village Office Place, Village at the Crossing, Champaign, Champaign County, Illinois, 61821-5359, United States

    CHAMPAIGN, IL 618227680

    Phone: (217) 351-7111

    Fax: (217) 351-7282

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-10-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20081030000231OClinic/Group PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61822)

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Reviews

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Frequently asked questions

How do payers reference AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD?
For AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD, use NPI 1215196290 as the unique 10-digit identifier.
Active or inactive — what applies to AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD?
You should see AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD as active in CMS-hosted NPPES data.
What clinical focus is listed for AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD?
At a glance, AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD is tied to Oral and Maxillofacial Surgery (Dentist). Clinical services aligned with this taxonomy classification.
What practice footprint exists for AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD?
Travel planning: use Champaign, Illinois as the reference point for AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD, then confirm.
When was this NPI issued?
Enumeration for AFFILIATES IN ORAL & MAXILLOFACIAL SURGERY LTD is noted as June 5, 2008 where the registry provides it.

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