Mirage Ambulatory Surgery Center, Inc

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

MIRAGE AMBULATORY SURGERY CENTER, INC

Practice address

39935 Vista del Sol
Suite 102
Rancho Mirage, CA 92270-3211

Phone

(760) 779-9989

Fax

(760) 779-9710

NPI assigned

Mar 4, 2010

Last updated

Mar 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen L. Kreizenbeck, DDSNPI 1962409268

Title

President

Phone

(760) 779-9989

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen L Kreizenbeck, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Rancho Mirage, CA
  • NPI 1962409268
  NPD (past) Authorized official
• Phillip M Seim, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • La Quinta, CA
  • NPI 1679570972
  NPD (past)

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267660800000",
    "number": "1154644193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39935 VISTA DEL SOL",
            "address_2": "SUITE 102",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703211",
            "telephone_number": "760-779-9989",
            "fax_number": "760-779-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39935 VISTA DEL SOL",
            "address_2": "SUITE 102",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703211",
            "telephone_number": "760-779-9989",
            "fax_number": "760-779-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAGE AMBULATORY SURGERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A",
        "authorized_official_last_name": "KREIZENBECK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-779-9989",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Sue Mills, PHARMD
• Todd Edward Miner, PT
• Evan R Minkoff, DO
• Ranjeet Minocha, M.D.
• Mirage Aesthetic Concepts Surgical Center
• Mirage Care LLC
• Mirage Center Outpatient Surgery
• Mirage Endoscopy Center, L.P.
• Mirage Medical Group
• Mirage on Call Medical Group Inc

• Oral and Maxillofacial Surgery Clinic/Center in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; 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.