NPIMap

Organization Active NPI

Yavapai Oral and Facial Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Prescott Valley, AZ
National Provider Identifier
1669885802
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D008900 Issued in AZ
Legal business name
YAVAPAI ORAL AND FACIAL SURGERY PLLC
Practice address
8101 E Florentine Rd
Prescott Valley, AZ 86314-8454
Phone
(928) 775-2545
Fax
(928) 775-2535
NPI assigned
Jun 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Mrs. Kathy S Dresher
Title
VP Billing
Phone
(405) 848-7974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X D008900 AZ Primary

Addresses

Primary practice location

8101 E Florentine Rd
Prescott Valley, AZ 86314-8454

Mailing address

PO Box 258848
Oklahoma City, OK 73125-8848
Phone (877) 667-7669

National Provider Directory

National Provider Directory

Locations

1747 Willow Creek Rd
Prescott, AZ 86301
Phone (602) 778-5527

Practitioners & affiliated clinicians

Practitioners 3

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": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1669885802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 258848",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731258848",
            "telephone_number": "877-667-7669",
            "fax_number": "405-848-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 E FLORENTINE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863148454",
            "telephone_number": "928-775-2545",
            "fax_number": "928-775-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAVAPAI ORAL AND FACIAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "DRESHER",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP BILLING",
        "authorized_official_telephone_number": "405-848-7974",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D008900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.