Oral and Facial Surgery Center of Prescott

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8911 Issued in AZ

Legal business name

ORAL AND FACIAL SURGERY CENTER OF PRESCOTT

Practice address

5415 Distiction Way
Prescott, AZ 86301

Phone

(205) 470-0047

NPI assigned

Feb 27, 2015

Organization subpart

No

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

Authorized official

Name

Benjamin Abt, DMD

Title

Owner/Provider

Phone

(205) 470-0047

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1275925265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 DISTICTION WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 DISTICTION WAY",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "205-470-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND FACIAL SURGERY CENTER OF PRESCOTT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-27",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "ABT",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "205-470-0047",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "8911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Henry Oliver, MS, LPC, NCC
• Debra Lynn Olsen, LMT
• Elizabeth Baysa Olson, CCC-SLP
• Timothy D Olthoff, DO
• Alayna Nicole Oneill, LMT
• Michael G Orr, MD
• Kathryn Ortega, NP-C
• Morgan Osborn, ND
• Larissa Osio, MS OTR/L
• Abdul-Fatawu Osman, MD

• Oral and Maxillofacial Surgery (Dentist) in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.