Colorado West Oral & Maxillofacial Surgery PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

104240 Issued in CO

Legal business name

COLORADO WEST ORAL & MAXILLOFACIAL SURGERY PC

Practice address

2530 N 8TH St Ste 103
Grand Junction, CO 81501-8856

Phone

(970) 245-2222

Fax

(970) 243-4438

NPI assigned

Jun 13, 2008

Last updated

Jan 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephen S. Kelly, DMDNPI 1528053204

Title

President

Phone

(970) 245-2222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen S. Kelly, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Junction, CO
  • NPI 1528053204
  Authorized official Same address or phone
• Jesse Lane Gray, D.D.S, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Grand Junction, CO
  • NPI 1750678538
  NPD

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1588824437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 N 8TH ST STE 103",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018856",
            "telephone_number": "970-245-2222",
            "fax_number": "970-243-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 N 8TH ST STE 103",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018856",
            "telephone_number": "970-245-2222",
            "fax_number": "970-243-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO WEST ORAL & MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-245-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "104240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04014940",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colorado West Healthcare System (Community Hospital Professional)
• Colorado West Healthcaresystem, Inc (CMG Primary Care 13)
• Colorado West Healthcaresystem, Inc (Grand valley Occupational Medicine)
• Colorado West Hearing Services-Aaa Hearing Service (AAA Hearing Services)
• Colorado West Oms PLLC (Colorado West Oral and Maxillofacial Surgery)
• Colorado West Otolaryngologists PC (ReGenesis Plastic Surgery & Dermatology)
• Colorado West Psychiatric Hospital, Inc. (Colorado West Psychiatric Hospital Pro Fees)
• Colorado West Psychiatric Hospital, Inc. (West Springs Hospital, Inc.)
• Colorado West Regional Mental Health Inc. (Health Solutions West)
• Colorado West Regional Mental Health Inc. (Mind Springs Health Inc)

• Specialist in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.