SJ Oral Surgery PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

183 Issued in OK

Legal business name

SJ ORAL SURGERY PC

Practice address

3632 W South Jordan Pkwy Ste 103
South Jordan, UT 84009-7163

Phone

(580) 355-6000

NPI assigned

Mar 27, 2018

Organization subpart

No

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

Authorized official

Name

Dayne Jensen, MD, DMD

Title

President

Phone

(801) 698-7121

Specialties & licenses 1

Addresses

Other names 1

• South Jordan Oral and Facial Surgery Doing business as

Locations

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1316442841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 W SOUTH JORDAN PKWY STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840097163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 W SOUTH JORDAN PKWY STE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840097163",
            "telephone_number": "580-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJ ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "DAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-698-7121",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OK",
            "license": "183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Jordan Oral and Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Simmons
• Jeffrey Lynn Simmons, OD
• Simply Dental of South Jordan, LLC
• Gina Sisk
• Elmer G Sisneros, PA
• Bryan Eugene Skiles, CMHC, LMHC
• Kosheila Slade
• SLC Walmart Eye Docs
• Sleep Alternatives Salt Lake , LLC
• Sleep Institute of Utah LC

• Oral and Maxillofacial Surgery (Dentist) in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.