Spring Park Oral and Maxillofacial Surgeons

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SPRING PARK ORAL AND MAXILLOFACIAL SURGEONS

Practice address

407 S 4TH St
Clinton, IA 52732-4512

Phone

(563) 243-4406

Fax

(563) 243-8534

NPI assigned

Mar 17, 2006

Organization subpart

No

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

Authorized official

Name

Martie Teshak

Title

Manager

Phone

(563) 359-1601

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194784389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S 4TH ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324512",
            "telephone_number": "563-243-4406",
            "fax_number": "563-243-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S 4TH ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527324512",
            "telephone_number": "563-243-4406",
            "fax_number": "563-243-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING PARK ORAL AND MAXILLOFACIAL SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TESHAK",
        "authorized_official_first_name": "MARTIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "563-359-1601"
    },
    "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": []
}

• Lisa Ann Smith, IAADC, CAADC
• Ashley Ann Snyder, ARNP
• Megan Lee Sokolovich, DNP, CPNP-PC
• Sasidhar Somuri, M.D
• Ashley Sotelo-Ashby, LISW
• Patricia K Stark, NBC-HIS
• Jeremy W Starr, PT
• Angela Staszewski
• Amanda Stecker
• Trisha Lynn Steddom

• Oral and Maxillofacial Surgery (Dentist) in Clinton, IA
• Providers in Clinton, IA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Iowa

• 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.