Trauma and Emergency Subspecialty Surgeons PLLC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

40115 Issued in CO

Legal business name

TRAUMA AND EMERGENCY SUBSPECIALTY SURGEONS PLLC

Practice address

1745 Shea Center Dr
Suite 400
Highlands Ranch, CO 80129-1537

Phone

(303) 774-1974

NPI assigned

Oct 13, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Brian J Willoughby, M.D.NPI 1962425710

Title

Sole Owner

Phone

(303) 320-5700

Specialties & licenses 2

Addresses

Practitioners 1

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

• Brian J Willoughby, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Denver, CO
  • NPI 1962425710
  NPD (past) Authorized official

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1225588221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 SHEA CENTER DR",
            "address_2": "SUITE 400",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801291537",
            "telephone_number": "303-774-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 SHEA CENTER DR",
            "address_2": "SUITE 400",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801291537",
            "telephone_number": "303-774-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA AND EMERGENCY SUBSPECIALTY SURGEONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "WILLOUGHBY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "303-320-5700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CO",
            "license": "40115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaina M Tonge, M.ED., BCBA
• Total Vitality LLC
• Trailhead Physical Therapy LLC
• Dzung Tran, PHARMD
• Thy Tran, RPH
• Trauma and Emergency Subspecialty Surgeons PLLC
• Janette E Trent, NP
• Trevia Counseling LLC
• Trina Triska, RN
• Schelly L Trojan, LPC

• Oral & Maxillofacial Surgery (D.M.D.) in Highlands Ranch, CO
• Providers in Highlands Ranch, CO by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.