NPIMap

Organization Active NPI

Oral Surgery Associates LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • West Bend, WI
National Provider Identifier
1235466988
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
5001856-15 Issued in WI
Legal business name
ORAL SURGERY ASSOCIATES LTD
Practice address
2100 Gateway CT
Suite 101
West Bend, WI 53095-8550
Phone
(262) 335-2282
Fax
(262) 335-2296
NPI assigned
Nov 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Authorized official

Name
Dr. Guy K. Jensen, DDS, MS
Title
Oral Surgeon
Phone
(920) 923-0111

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 5001856-15 WI Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 5000111-15 WI
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 2787-15 WI

Addresses

Primary practice location

2100 Gateway CT
Suite 101
West Bend, WI 53095-8550

Mailing address

2100 Gateway CT.
Suite 101
West Bend, WI 53095-8556
Phone (262) 335-2282

National Provider Directory

National Provider Directory
Tax ID family
Oral Surgery Assoc LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2100 Gateway Ct
Ste 101
West Bend, WI 53095
Phone (262) 335-2282

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1235466988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 GATEWAY CT.",
            "address_2": "SUITE 101",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958556",
            "telephone_number": "262-335-2282",
            "fax_number": "262-335-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GATEWAY CT",
            "address_2": "SUITE 101",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958550",
            "telephone_number": "262-335-2282",
            "fax_number": "262-335-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL SURGERY ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "920-923-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5001856-15",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5000111-15",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "2787-15",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.