NPIMap

Organization Active NPI

Southwest Orofacial Group, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Phoenix, AZ
National Provider Identifier
1245620459
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
SOUTHWEST OROFACIAL GROUP, INC.
Practice address
4350 E Ray Rd Ste 103
Phoenix, AZ 85044-4704
Phone
(602) 992-1486
NPI assigned
Jan 26, 2015
Last updated
Mar 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Authorized official

Name
Therese Garvey
Title
Owner
Phone
(602) 992-1486

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X NU
Dentist 122300000X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary
Orofacial Pain Dentistry 1223X2210X NU

Addresses

Primary practice location

4350 E Ray Rd Ste 103
Phoenix, AZ 85044-4704

Mailing address

10214 N Tatum Blvd Ste A1100
Phoenix, AZ 85028-4243
Phone (602) 992-1486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080124000255 AZ Part B Supplier - Clinic/Group Practice 4981786308 Receives reassigned benefits from 4 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mesa, AZ; Peoria, AZ; Phoenix, AZ; Tempe, AZ
O20150731016573 AZ DME Supplier - Oral Surgery - Dentist 4981786308 Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Southwest Orofacial Group4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

4350 E Ray Rd
Ste 103
Phoenix, AZ 85044
Phone (602) 992-1486

2034 E Southern Ave
Ste Ef
Tempe, AZ 85282

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1245620459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10214 N TATUM BLVD STE A1100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850284243",
            "telephone_number": "602-992-1486",
            "fax_number": "602-992-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 E RAY RD STE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444704",
            "telephone_number": "602-992-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST OROFACIAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "GARVEY",
        "authorized_official_first_name": "THERESE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-992-1486"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.