NPIMap

Organization Active NPI

Sonoma Oral & Facial Surgery, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Gilbert, AZ
National Provider Identifier
1477063881
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
7166 Issued in AZ
Legal business name
SONOMA ORAL & FACIAL SURGERY, PLLC
Practice address
7400 S Power Rd Ste 136
Gilbert, AZ 85297-9284
Phone
(480) 279-3113
Fax
(480) 279-2741
NPI assigned
Oct 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Authorized official

Name
Dr. Peter A Spanganberg, DDS
Title
DDS/Owner
Phone
(480) 279-3113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 7166 AZ Primary

Addresses

Primary practice location

7400 S Power Rd Ste 136
Gilbert, AZ 85297-9284

Mailing address

7400 S Power Rd Ste 136
Gilbert, AZ 85297-9284
Phone (480) 279-3113

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507680000000",
    "number": "1477063881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 S POWER RD STE 136",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979284",
            "telephone_number": "480-279-3113",
            "fax_number": "480-279-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 S POWER RD STE 136",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979284",
            "telephone_number": "480-279-3113",
            "fax_number": "480-279-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA ORAL & FACIAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2017-10-11",
        "status": "A",
        "authorized_official_last_name": "SPANGANBERG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "480-279-3113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "7166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.