Creekside Oral & Facial Surgery Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

315501-9924 Issued in UT

Legal business name

CREEKSIDE ORAL & FACIAL SURGERY INC

Practice address

7390 S Creek Rd
Suite 101
Sandy, UT 84093-6119

Phone

(801) 255-2422

Fax

(801) 255-3013

NPI assigned

Sep 30, 2015

Organization subpart

No

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

Authorized official

Name

Dr. David Max Anderson, DDS MD

Title

President

Phone

(801) 255-2422

Specialties & licenses 1

Addresses

Other names 1

• Creekside Oral Surgery Other name

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1679943831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7390 S CREEK RD",
            "address_2": "SUITE 101",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936119",
            "telephone_number": "801-255-2422",
            "fax_number": "801-255-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7390 S CREEK RD",
            "address_2": "SUITE 101",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936119",
            "telephone_number": "801-255-2422",
            "fax_number": "801-255-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE ORAL & FACIAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MAX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-255-2422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "315501-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creekside Oral Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Creed S Haymond DDS PC
• Creek Capital Lone Peak LLC (Burg Children's Dentistry & Orthodontics- Lone Peak)
• Creek Road Dental
• Creek Road Orthodontics and Pediatric Dentistry
• Creek Road Smiles LLC
• Holli Crosby, ACMHC
• Crossover Health Medical Group
• Crossroads Therapeutic Services, LLC
• Krista L Crown, PTA
• Crownbrook Inc (Hawkins Chiropractic)

• Oral and Maxillofacial Surgery (Dentist) in Sandy, UT
• Providers in Sandy, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.