Az Max Surgeons PLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

AZ MAX SURGEONS PLC

Practice address

6755 E Superstition Springs Blvd Ste 103
Mesa, AZ 85206-4375

Phone

(480) 830-5866

Fax

(480) 807-0606

NPI assigned

Dec 19, 2018

Organization subpart

No

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

Authorized official

Name

Jilian Porter

Title

Credentialing Coordinator

Phone

(480) 830-5866

Specialties & licenses 1

Addresses

Other names 1

• Arizona Maxillofacial Surgeons PC Former legal business name

Locations

Practitioners 5

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

• Robert Brinks Austin, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mesa, AZ
  • NPI 1891772505
  NPD (past)
• Brent Russell Boyse, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mesa, AZ
  • NPI 1609853365
  NPD (past)
• Duane Lemieux, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Queen Creek, AZ
  • NPI 1699279026
  NPD (past)
• Bradley Thain Porter, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mesa, AZ
  • NPI 1023095734
  NPD (past)
• Gregory Romney, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mesa, AZ
  • NPI 1972823029
  NPD (past)

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1528530284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6755 E SUPERSTITION SPRINGS BLVD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064375",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6755 E SUPERSTITION SPRINGS BLVD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064375",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18610 E Rittenhouse Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851424504",
            "country_code": "US",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 S White Mountain Rd",
            "address_purpose": "LOCATION",
            "city": "Show Low",
            "state": "AZ",
            "postal_code": "859016105",
            "country_code": "US",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7350 S McClintock Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852835006",
            "country_code": "US",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6808 E Brown Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852073705",
            "country_code": "US",
            "telephone_number": "480-830-5866",
            "fax_number": "480-807-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AZ MAX SURGEONS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-19",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "JILIAN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "480-830-5866"
    },
    "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": [
        {
            "organization_name": "Arizona Maxillofacial Surgeons PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.