NPIMap

Organization Active NPI

Advanced Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Englewood, CO
National Provider Identifier
1073109690
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ADVANCED ORAL & MAXILLOFACIAL SURGERY
Practice address
10120 E Dry Creek Rd Ste 100
Englewood, CO 80112-2772
Phone
(303) 768-8570
Fax
(303) 768-8570
NPI assigned
Dec 17, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Cheree Jubin
Title
Practice Manager
Phone
(303) 768-8570

Practitioners 3

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

National Provider Directory

National Provider Directory
Tax ID family
Advanced Oral Maxillofacial Surgery4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10120 E Dry Creek Rd
Ste 100
Englewood, CO 80112
Phone (303) 768-8570

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

NPPES NPI Registry

Primary practice location

10120 E Dry Creek Rd Ste 100
Englewood, CO 80112-2772

Mailing address

10120 E Dry Creek Rd Ste 100
Englewood, CO 80112-2772
Phone (303) 768-8570

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2020.

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1073109690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10120 E DRY CREEK RD STE 100",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801122772",
            "telephone_number": "303-768-8570",
            "fax_number": "303-768-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10120 E DRY CREEK RD STE 100",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801122772",
            "telephone_number": "303-768-8570",
            "fax_number": "303-768-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "JUBIN",
        "authorized_official_first_name": "CHEREE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "303-768-8570"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.