Glacier Oral & Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

GLACIER ORAL & MAXILLOFACIAL SURGERY

Practice address

515 Hwy 9 Ste 102
Lake Stevens, WA 98258-8523

Phone

(425) 439-7446

NPI assigned

Mar 27, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Noblitt, DMDNPI 1578910998

Title

Owner Dentist

Phone

(425) 293-1372

Specialties & licenses 1

Addresses

Practitioners 1

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

• Benjamin R Noblitt, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Stevens, WA
  • NPI 1578910998
  NPD Authorized official

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

{
    "created_epoch": "1774569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774569600000",
    "number": "1083553630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7718 19TH PL SE",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982583212",
            "telephone_number": "425-293-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 HWY 9 STE 102",
            "city": "LAKE STEVENS",
            "state": "WA",
            "postal_code": "982588523",
            "telephone_number": "425-439-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-27",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A",
        "authorized_official_last_name": "NOBLITT",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "425-293-1372",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Z Gandhi-Besbes, DPT, PT
• Russell German
• Erik Richard Geving
• Ramy Gewida, PHARMD
• Heather Maridawn Gilman, LMP
• Tobey Gloss, LPN
• Sarah N Gordon, OTR/L
• Marsha Marie Graf, LMP
• Kevin P Graham, PT
• Lydia Laurel Grauer, DPT

• Oral and Maxillofacial Surgery Clinic/Center in Lake Stevens, WA
• Providers in Lake Stevens, WA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.