NPIMap

Organization Active NPI

Douglas Maxson

  • Oral and Maxillofacial Surgery Clinic/Center
  • San Jose, CA
National Provider Identifier
1023666989
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
DOUGLAS MAXSON
Practice address
1198 S de Anza Blvd
San Jose, CA 95129-3632
Phone
(408) 996-0176
NPI assigned
Sep 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Douglas MaxsonNPI 1134241789
Title
Owner
Phone
(408) 996-0176

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

1198 S de Anza Blvd
San Jose, CA 95129-3632

Mailing address

1198 S de Anza Blvd
San Jose, CA 95129-3632

Other names 1

  • DOUGLAS R MAXSON DDS Other name

National Provider Directory

National Provider Directory

Locations

1198 S De Anza Blvd
San Jose, CA 95129
Phone (408) 996-0176

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1023666989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1198 S DE ANZA BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1198 S DE ANZA BLVD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951293632",
            "telephone_number": "408-996-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS MAXSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "MAXSON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-996-0176"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOUGLAS R MAXSON DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.