NPIMap

Organization Active NPI

Davis Center for Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Pathology Dentistry
  • Layton, UT
National Provider Identifier
1093713554
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
4124 Issued in UT
Legal business name
DAVIS CENTER FOR ORAL & MAXILLOFACIAL SURGERY
Practice address
890 W Heritage Park Blvd.
Suite 103
Layton, UT 84041
Phone
(801) 614-0999
Fax
(801) 614-0998
NPI assigned
Jul 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul Benson, DMD
Title
Owner
Phone
(801) 614-0999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0106X 4124 UT Primary

Addresses

Primary practice location

890 W Heritage Park Blvd.
Suite 103
Layton, UT 84041

Mailing address

890 W Heritage Park Blvd.
Suite 103
Layton, UT 84041
Phone (801) 614-0999

National Provider Directory

National Provider Directory

Locations

890 Heritage Park Blvd
Ste 103
Layton, UT 84041
Phone (801) 614-0999

890 Heritage Park Blvd
Layton, UT 84041
Phone (801) 614-0999

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093713554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 W HERITAGE PARK BLVD.",
            "address_2": "SUITE 103",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-614-0999",
            "fax_number": "801-614-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 W HERITAGE PARK BLVD.",
            "address_2": "SUITE 103",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-614-0999",
            "fax_number": "801-614-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS CENTER FOR ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-614-0999",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "UT",
            "license": "4124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • 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.