Magic Valley Oral Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D1658 Issued in ID

Legal business name

MAGIC VALLEY ORAL SURGERY

Practice address

590 Falls Ave
Twin Falls, ID 83301-3314

Phone

(208) 734-3562

Fax

(208) 736-8339

NPI assigned

May 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Vincent Lynn Williams, DMD

Title

Ownerpresident

Phone

(208) 734-3562

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073720009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 FALLS AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013314",
            "telephone_number": "208-734-3562",
            "fax_number": "208-736-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FALLS AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013314",
            "telephone_number": "208-734-3562",
            "fax_number": "208-736-8339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGIC VALLEY ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNERPRESIDENT",
        "authorized_official_telephone_number": "208-734-3562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D1658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magic Valley Family Practice, PLLC
• Magic Valley Foot and Ankle Specialists PLLC
• Magic Valley Kidney Institute LLP
• Magic Valley Medicine PLLC
• Magic Valley Medicine PLLC
• Magic Valley Orthodontics PLLC
• Magic Valley Paramedics , LTD.
• Magic Valley Paramedics L L C
• Magic Valley Regional Medical Center
• Magic Valley Regional Medical Center

• Oral and Maxillofacial Surgery (Dentist) in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Oral and Maxillofacial Surgery (Dentist) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.