NPIMap

Organization Active NPI

Wenatchee Valley Oral and Facial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Wenatchee, WA
National Provider Identifier
1689090110
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
DE60337452 Issued in WA
Legal business name
WENATCHEE VALLEY ORAL AND FACIAL SURGERY
Practice address
620 N Emerson Ave
Suite 101
Wenatchee, WA 98801-6619
Phone
(509) 663-0068
Fax
(509) 663-0060
NPI assigned
Mar 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Authorized official

Name
Dr. Jeremiah Johnson, DDS, MDNPI 1922119189
Title
Doctor
Phone
(509) 663-0060

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X DE60337452 WA Primary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X MD60336798 WA
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X D9077 OR

Addresses

Primary practice location

620 N Emerson Ave
Suite 101
Wenatchee, WA 98801-6619

Mailing address

620 N Emerson Ave
Suite 101
Wenatchee, WA 98801-6619
Phone (509) 663-0068

National Provider Directory

National Provider Directory

Locations

620 N Emerson Ave
Ste 101
Wenatchee, WA 98801
Phone (509) 663-0068

Practitioners & affiliated clinicians

Practitioners 2

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": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1689090110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N EMERSON AVE",
            "address_2": "SUITE 101",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988016619",
            "telephone_number": "509-663-0068",
            "fax_number": "509-663-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N EMERSON AVE",
            "address_2": "SUITE 101",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988016619",
            "telephone_number": "509-663-0068",
            "fax_number": "509-663-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENATCHEE VALLEY ORAL AND FACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "509-663-0060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60337452",
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "MD60336798",
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D9077",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.