Organization Active NPI

Oral & Facial Reconstructive Surgeons of Utah, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Salt Lake City, UT
National Provider Identifier
1184980005
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7961990-1205 Issued in UT
Legal business name
ORAL & FACIAL RECONSTRUCTIVE SURGEONS OF UTAH, LLC
Practice address
1250 E 3900 S Ste 360
Salt Lake City, UT 84124-1362
Phone
(801) 262-7447
NPI assigned
Apr 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Dr. Nathan Grant Adams, MD, DMD
Title
Co-Owner, Surgeon
Phone
(801) 262-7447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 7961990-1205 UT Primary

Addresses

Primary practice location

1250 E 3900 S Ste 360
Salt Lake City, UT 84124-1362

Mailing address

1250 E 3900 S Ste 360
Salt Lake City, UT 84124-1362
Phone (801) 262-7447

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1184980005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 360",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241362",
            "telephone_number": "801-262-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 360",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241362",
            "telephone_number": "801-262-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL & FACIAL RECONSTRUCTIVE SURGEONS OF UTAH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "CO-OWNER, SURGEON",
        "authorized_official_telephone_number": "801-262-7447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "7961990-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.