ORAL SURGERY ASSOCIATES LTD NPI 1235466988

NPI Information

  • NPI: 1235466988
  • Provider Name: ORAL SURGERY ASSOCIATES LTD
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 2100 GATEWAY CT
    SUITE 101
    WEST BEND, WI
    ZIP 53095
  • Phone: (262) 335-2282

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NPI Details

ORAL SURGERY ASSOCIATES LTD is an oral and maxillofacial surgery dentist in West Bend, WI. 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 SURGERY ASSOCIATES LTD NPI is 1235466988. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2100 GATEWAY CT
SUITE 101
WEST BEND, WI
ZIP 53095-550
Phone: (262) 335-2282
Fax: (262) 335-2296

The provider's authorized official is Guy K. Jensen .
The authorized official title is Oral Surgeon and has the following contact phone number (920) 923-0111.

The enumeration date for this NPI number is 11/17/2009 and was last updated on 11/17/2009.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery5000111-15WISCONSINNo
21223S0112XDentistOral and Maxillofacial Surgery2787-15WISCONSINNo
31223S0112XDentistOral and Maxillofacial Surgery5001856-15WISCONSINYes

What is NPI?

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This page was last updated on: 11/21/2025

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