NPIMap

Organization Active NPI

Center for Corrective Jaw & Facial Surgery ....

  • Oral and Maxillofacial Surgery (Dentist)
  • Fresno, CA
National Provider Identifier
1508938523
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
CENTER FOR CORRECTIVE JAW & FACIAL SURGERY ....
Practice address
7055 N Fresno St #202
Fresno, CA 93720
Phone
(559) 432-4911
Fax
(559) 432-3515
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Leon Anton Jonker, DDSNPI 1962570655
Title
President
Phone
(559) 432-4911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

7055 N Fresno St #202
Fresno, CA 93720

Mailing address

7055 N Fresno St #202
Fresno, CA 93720
Phone (559) 432-4911

National Provider Directory

National Provider Directory

Locations

7055 N Fresno St
Ste 202
Fresno, CA 93720
Phone (559) 432-4911

Practitioners & affiliated clinicians

Practitioners 5

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508938523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7055 N FRESNO ST #202",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-432-4911",
            "fax_number": "559-432-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7055 N FRESNO ST #202",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-432-4911",
            "fax_number": "559-432-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR CORRECTIVE JAW & FACIAL SURGERY ....",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONKER",
        "authorized_official_first_name": "LEON",
        "authorized_official_middle_name": "ANTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-432-4911",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.