NPIMap

Organization Active NPI

Davis Center for Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Layton, UT
National Provider Identifier
1407085160
Registry record updated Jul 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
5889917 Issued in UT
Legal business name
DAVIS CENTER FOR ORAL & MAXILLOFACIAL SURGERY
Practice address
890 Heritage Park Blvd Ste 103
Layton, UT 84041-5622
Phone
(801) 614-0999
NPI assigned
Jul 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2009

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

Authorized official

Name
Kerri Jewkes
Title
Office Manager
Phone
(801) 614-0999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 5889917 UT Primary

Addresses

Primary practice location

890 Heritage Park Blvd Ste 103
Layton, UT 84041-5622

Mailing address

890 Heritage Park Blvd Ste 103
Layton, UT 84041-5622
Phone (801) 614-0999

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246492800000",
    "number": "1407085160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 HERITAGE PARK BLVD STE 103",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415622",
            "telephone_number": "801-614-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 HERITAGE PARK BLVD STE 103",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840415622",
            "telephone_number": "801-614-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS CENTER FOR ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-02",
        "last_updated": "2009-07-02",
        "status": "A",
        "authorized_official_last_name": "JEWKES",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-614-0999"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "5889917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.