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SOUTHWEST CENTER FOR ORAL SURGERY PLLC NPI 1336689140


NPI Information

NPI: 1336689140
Provider Name: SOUTHWEST CENTER FOR ORAL SURGERY, PLLC

Doing Business As: SOUTHWEST ORAL SURGERY

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
4600 E SHEA BLVD
#201
PHOENIX, AZ
ZIP 85028
Phone: (623) 792-5794
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SOUTHWEST CENTER FOR ORAL SURGERY, PLLC 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. SOUTHWEST CENTER FOR ORAL SURGERY, PLLC NPI is 1336689140. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Southwest Oral Surgery.

The provider's business location address is:

4600 E SHEA BLVD
#201
PHOENIX, AZ
ZIP 85028-024
Phone: (623) 792-5794
Fax: (623) 792-5809

The provider's authorized official is Fawne Rogers .
The authorized official title is Practice Manager and has the following contact phone number (623) 792-5794.

The enumeration date for this NPI number is 2/27/2017 and was last updated on 2/27/2017.


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 SurgeryD8077ARIZONAYes
21223S0112XDentistOral and Maxillofacial SurgeryD9133ARIZONANo
31223S0112XDentistOral and Maxillofacial SurgeryD3178ARIZONANo

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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