Oral Maxillofacial Surgery PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAL MAXILLOFACIAL SURGERY PLLC

Practice address

777 N 500 W
Suite 102
Provo, UT 84601-1541

Phone

(801) 375-4707

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Janine Gale

Title

Asst. Office Manager

Phone

(801) 375-4707

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1497838577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 102",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011541",
            "telephone_number": "801-375-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N 500 W",
            "address_2": "SUITE 102",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011541",
            "telephone_number": "801-375-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL MAXILLOFACIAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "GALE",
        "authorized_official_first_name": "JANINE",
        "authorized_official_title_or_position": "ASST. OFFICE MANAGER",
        "authorized_official_telephone_number": "801-375-4707"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "64166",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Ferron Olson, M.D.
• Tamara Olson, 101YA0400X
• Benjamin Ooi
• Kiersten Openshaw
• Optimal Health Family Practice
• Ariah Orchard
• Nina Ann Orchard
• Jennifer Maria Pia Orellana Paredes
• Michelle Orellana
• Matthew Orgill, OD

• Oral and Maxillofacial Surgery (Dentist) in Provo, UT
• Providers in Provo, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.