ORAL SURGERY LTD NPI 1255421897

NPI Information

  • NPI: 1255421897
  • Provider Name: ORAL SURGERY LTD
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 1277 E MISSOURI AVE
    #110
    PHOENIX, AZ
    ZIP 85014
  • Phone: (602) 248-8745

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NPI Details

ORAL SURGERY LTD is an oral and maxillofacial surgery dentist in Phoenix, AZ. 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 LTD NPI is 1255421897. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1277 E MISSOURI AVE
#110
PHOENIX, AZ
ZIP 85014-915
Phone: (602) 248-8745
Fax: (602) 248-7939

The provider's authorized official is Lee Robert Raddatz .
The authorized official title is President and has the following contact phone number (602) 248-8745.

The enumeration date for this NPI number is 10/13/2006 and was last updated on 8/22/2020.

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 Surgery1421ARIZONAYes

What is NPI?

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

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