Excellence in Oral & Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

6709 Issued in CO

Legal business name

EXCELLENCE IN ORAL & MAXILLOFACIAL SURGERY

Practice address

1755 Telstar Dr
Suite 210
Colorado Springs, CO 80920-1016

Phone

(719) 592-9222

Fax

(719) 592-9682

NPI assigned

Apr 29, 2014

Organization subpart

No

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

Authorized official

Name

Vikki Biernacki

Title

Practice Manager

Phone

(719) 592-9222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1114337136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 TELSTAR DR",
            "address_2": "SUITE 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201016",
            "telephone_number": "719-592-9222",
            "fax_number": "719-592-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 TELSTAR DR",
            "address_2": "SUITE 210",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201016",
            "telephone_number": "719-592-9222",
            "fax_number": "719-592-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENCE IN ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "BIERNACKI",
        "authorized_official_first_name": "VIKKI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "719-592-9222"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "6709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.