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ORAL MAXILLOFACIAL SURGERY PLLC NPI 1497838577


NPI Information

NPI: 1497838577
Provider Name: ORAL MAXILLOFACIAL SURGERY PLLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
777 N 500 W
SUITE 102
PROVO, UT
ZIP 84601
Phone: (801) 375-4707
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ORAL MAXILLOFACIAL SURGERY PLLC is an oral and maxillofacial surgery dentist in Provo, UT. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. ORAL MAXILLOFACIAL SURGERY PLLC NPI is 1497838577. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

777 N 500 W
SUITE 102
PROVO, UT
ZIP 84601-541
Phone: (801) 375-4707

The provider's authorized official is Janine Gale .
The authorized official title is Asst. Office Manager and has the following contact phone number (801) 375-4707.

The enumeration date for this NPI number is 10/23/2006 and was last updated on 4/7/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
164166OTHERUTAHPEHP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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