Innovative Implant & Oral Surgery Pc
Oral & Maxillofacial Surgery
1300 Bridgetown Pike, Feasterville Trevose
Pennsylvania, 19053-4326
215-322-7810 215-322-7832
Innovative Implant & Oral Surgery Pc is a Oral & Maxillofacial Surgery in Feasterville Trevose, Pennsylvania. It is located at 1300 Bridgetown Pike, Feasterville Trevose and it's customer support contact number is 215-322-7810. The authorized person of Innovative Implant & Oral Surgery Pc is Ms. Debra Robyn Lodise who is Office Manager of this DME and her contact number is 215-322-7810. Innovative Implant & Oral Surgery Pc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Innovative Implant & Oral Surgery Pc is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
DME Supplier Details:
Innovative Implant & Oral Surgery Pc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Innovative Implant & Oral Surgery Pc |
| Type: | Oral & Maxillofacial Surgery |
| Location: | 1300 Bridgetown Pike, Feasterville Trevose,
Pennsylvania, 19053-4326 |
| Phone: | 215-322-7810 |
| Fax: | 215-322-7832 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Debra Robyn Lodise |
| Position: | Office Manager |
| Contact Number: | 215-322-7810 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1679547707 |
| NPI Enumeration Date: | 15 Feb, 2006 |
| NPI Last Update On: | 23 Jan, 2026 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Innovative Implant & Oral Surgery Pc are as mentioned below.
| Specialization | License Number | State | Status | |
| Oral & Maxillofacial Surgery | | | Primary | |
| Customized Equipment | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1615888 | Other | Pennsylvania | Salin Blue Shield |
| 0547613000 | Other | Pennsylvania | Keyst Group# |
| 4437 | Other | Pennsylvania | Aetna Nissman |
| 161558 | Other | Pennsylvania | Nissman Blue Shield |
| 747908 | Other | Pennsylvania | Blue Shield Group# |
Medicare Enrollment:
Innovative Implant & Oral Surgery Pc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 3375635642 | O20070816000828 | Innovative Implant & Oral Surgery Pc | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1300 Bridgetown Pike,
Feasterville Trevose, Pennsylvania |
| Zip: | 19053-4326 |
| Phone Number: | 215-322-7810 |
| Fax Number: | 215-322-7832 |
Patients can reach Innovative Implant & Oral Surgery Pc at
1300 Bridgetown Pike, Feasterville Trevose, Pennsylvania or can
call on customer care at 215-322-7810.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 February, 2026.