Oral and Maxillofacial Surgery of Longmont LLC

Primary specialty

DentistTaxonomy code 122300000X

License

8762 Issued in CO

Legal business name

ORAL AND MAXILLOFACIAL SURGERY OF LONGMONT LLC

Practice address

1361 Francis Street
Suite 101
Longmont, CO 80501

Phone

(303) 772-8585

Fax

(303) 776-4895

NPI assigned

Apr 18, 2008

Organization subpart

No

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

Authorized official

Name

Douglas L Squire, DDS

Title

Owner

Phone

(303) 772-8585

Specialties & licenses 1

Addresses

Tax ID family

Oral and Maxillofacial Surgery of Longmont LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Squire Oral, Facial & Dental Implant Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Longmont, CO
  • NPI 1396020657
  NPD tax ID

Locations

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1508030750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 FRANCIS STREET",
            "address_2": "SUITE 101",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "303-772-8585",
            "fax_number": "303-776-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 FRANCIS STREET",
            "address_2": "SUITE 101",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80501",
            "telephone_number": "303-772-8585",
            "fax_number": "303-776-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL AND MAXILLOFACIAL SURGERY OF LONGMONT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "SQUIRE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-772-8585",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CO",
            "license": "8762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer A Olson
• Katherine K Olson, PA
• Optometric Associates PC (Eagle Vision & Eye Clinic PC)
• Optumcare Colorado Medical Group LLC (Colorado Center for Arthritis and Osteoporosis)
• Yaira Oquendo-Figueroa, PHD
• Anibal Orecchio, LMT
• Patrica A Oreilly, LSW
• Laura Orozco, PHARMD
• Andrea Orrison, M.A.
• Amanda Ortega, LMFT

• Dentist in Longmont, CO
• Providers in Longmont, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.