Valley Oral & Facial Surgery PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

VALLEY ORAL & FACIAL SURGERY PC

Practice address

2701 9TH Ave S Ste F
Fargo, ND 58103-8712

Phone

(701) 772-7379

Fax

(701) 772-9643

NPI assigned

Aug 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Troy Richard Petersen, DMD MDNPI 1073697157

Title

President

Phone

(701) 772-7379

Specialties & licenses 1

Addresses

Tax ID family

Valley Oral Facial Surgery PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Valley Oral & Facial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Forks, ND
  • NPI 1093133696
  NPD tax ID
• Valley Oral & Facial Surgery PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Grand Forks, ND
  • NPI 1801959788
  NPD tax ID

Locations

Practitioners 1

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

• Troy R Petersen, DMD MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Forks, ND
  • NPI 1073697157
  NPD (past) Authorized official

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1396978136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 9TH AVE S STE F",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038712",
            "telephone_number": "701-772-7379",
            "fax_number": "701-772-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 9TH AVE S STE F",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038712",
            "telephone_number": "701-772-7379",
            "fax_number": "701-772-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY ORAL & FACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-772-7379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Dental Center, PC
• Valley Dermatology Clinic PC
• Valley Homes LLC
• Valley Laser Eye Center L.L.C.
• Valley Medical Clinic PC
• Valley Senior Services
• Valley Service Heating & Ac
• Tanner Valnes
• Van Dam Chiropractic, PC
• Scott A Van Dam, DC

• Oral and Maxillofacial Surgery Clinic/Center in Fargo, ND
• Providers in Fargo, ND by specialty
• Oral and Maxillofacial Surgery Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.