Longmont Oral, Facial & Implant Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DEN.00010071 Issued in CO

Legal business name

LONGMONT ORAL, FACIAL & IMPLANT SURGERY

Practice address

1551 Professional LN Unit 260
Longmont, CO 80501-6903

Phone

(303) 772-8870

Fax

(303) 772-8871

NPI assigned

Apr 4, 2017

Organization subpart

No

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

Authorized official

Name

Jamie Leos

Title

Practice Administrator

Phone

(303) 772-8870

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Benjamin T Howard, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Longmont, CO
  • NPI 1386808533

  Oral and Maxillofacial Surgery

  NPD (past)
• Kevin Michael Andrus, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Chicago, IL
  • NPI 1689797243

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1366975765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN UNIT 260",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016903",
            "telephone_number": "303-772-8870",
            "fax_number": "303-772-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 PROFESSIONAL LN UNIT 260",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016903",
            "telephone_number": "303-772-8870",
            "fax_number": "303-772-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGMONT ORAL, FACIAL & IMPLANT SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "LEOS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "303-772-8870"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "DEN.00201841",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "DEN.00010071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1386808533",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689797243",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Longmont Hospitalist Group, LLC
• Longmont Integrative Family Practice PLLC
• Longmont Joint and Spine, LLC
• Longmont Medical Investors, LTD
• Longmont Modern Dentistry and Orthodontics, LLP
• Longmont Orthopedics PC
• Longmont Psychiatric Associates, P.C.
• Longmont Pulmonary and Critical Care Associates, PC
• Longmont Restorative Dentistry PLLC
• Longmont Sleep Diagnostics Inc

• All providers in Longmont, CO
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.