NPI age
11 years
Enumerated 2014-05-27
● Active Type 2 · Organization
Oral Surgery Of West Augusta Pc
Oral Surgery Of West Augusta Pc is 1 of 48 oral & maxillofacial surgery organizations in Georgia.
Primary specialty
Oral & Maxillofacial Surgery
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Sidow
Owner Surgeon
Last NPPES update
2014-05-27
Source: monthly bulk 2026-05
How this organization compares
Across 48 active oral & maxillofacial surgery providers in Georgia.
NPI age
11 years
↓ 5 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2014 → 2026
2014-05Enumerated in NPPES
2014
2026
Where they practice
Primary practice location
3634 Wheeler Rd
Augusta, GA 309096518
Mailing address
3634 Wheeler Rd
Augusta, GA 309096518
Authorized official
Boris J Sidow, D.D.S.
Owner Surgeon
📞 7068608228
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Pratikkumar Patel, DDS Dentist NPI 1093215881
- Ronald Peacock, D.D.S. Dentist NPI 1205022779
- Robert Rafoth, D.D.S. Dentist NPI 1659567121
Specialties
-
Oral & Maxillofacial Surgery PrimaryOral 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 000848645 | TRICARE ACTIVE DUTY DENTAL PLAN |
| 01 | 000425742 | TRICARE ACTIVE DUTY DENTAL PLAN |
| 05 (GA) | 111331508B | |
| 05 (GA) | 000056438C | |
| 01 | 002068046 | TRICARE ACTIVE DUTY DENTAL PLAN |
| 05 (GA) | 000056427C |
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.