Elison Oral and Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ELISON ORAL AND MAXILLOFACIAL SURGERY

Practice address

2588 Channing Way
Idaho Falls, ID 83404-7515

Phone

(208) 524-3200

NPI assigned

Dec 7, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark Turney Elison, DMD

Title

President

Phone

(208) 524-3200

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Lyle Kris Munk, DDS

  • Dentist
  • Idaho Falls, ID
  • NPI 1417034190
  NPD (past)

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260144000000",
    "number": "1114255916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047467",
            "telephone_number": "208-529-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2588 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047515",
            "telephone_number": "208-524-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISON ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2009-12-07",
        "status": "A",
        "authorized_official_last_name": "ELISON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "TURNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-524-3200",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elevate Academy East Idaho
• Elevate Anesthesia LLC
• Elevated Healing Services LLC
• Elevation Counseling
• Elison Dental Center
• Elison Orthodontics PLLC
• Joseph Hyrum Elison, DDSMS
• Joseph Matthew Elison, DDSMS
• Michael Aaron Elison, DMD
• Elite Dental Care, PLLC

• Oral and Maxillofacial Surgery (Dentist) in Idaho Falls, ID
• Providers in Idaho 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 Dec 7, 2009; 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.