Face and Jaw Surgeons PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

FACE AND JAW SURGEONS PC

Practice address

1517 12 Ave NE
Jamestown, ND 58401

Phone

(701) 239-5969

NPI assigned

Oct 16, 2020

Last updated

Oct 16, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

FACE AND JAW SURGEONS PCAs reported in NPPES

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

Authorized official

Name

Melinda Kleinjan

Title

Office Manager

Phone

(701) 258-7220

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Face & Jaw Surgeons, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Dickinson, ND
  • NPI 1730897026

  O20040514000837

  Same enrollment
• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Minot, ND
  • NPI 1104863505

  O20040514000837

  Same enrollment
• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bismarck, ND
  • NPI 1184667305

  O20040514000837

  Same enrollment
• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fargo, ND
  • NPI 1295804300

  O20040514000837

  Same enrollment
• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Forks, ND
  • NPI 1457420564

  O20040514000837

  Same enrollment

Tax ID family

Face and Jaw Surgeons PC5 organizations share this tax ID, including this one

Part of

Face and Jaw Surgeons PC

Other organizations with this tax ID 4

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

• Face & Jaw Surgeons, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Dickinson, ND
  • NPI 1730897026
  NPD tax ID
• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bismarck, ND
  • NPI 1184667305
  NPD tax ID
• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Fargo, ND
  • NPI 1295804300
  NPD tax ID
• Face and Jaw Surgeons PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Forks, ND
  • NPI 1457420564
  NPD tax ID

Locations

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602806400000",
    "number": "1396343737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4344 20TH AVE S STE 2",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037436",
            "telephone_number": "701-239-5969",
            "fax_number": "701-239-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 12 AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "58401",
            "telephone_number": "701-239-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACE AND JAW SURGEONS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FACE AND JAW SURGEONS PC",
        "enumeration_date": "2020-10-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "KLEINJAN",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "701-258-7220"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eventide Jamestown LLC
• Daniel D Everson, LCAC
• Samantha Everson
• Lori Mae Evjen, LAC
• Nancy Ann Exner, LPCC, LAC, LSW
• Allen Robert Falk
• Kara A Falk, NP
• Tammy Jo Falk
• Alison M Fallgatter, DDS, MS
• Brenna Fallis

• Oral and Maxillofacial Surgery (Dentist) in Jamestown, ND
• Providers in Jamestown, ND by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.