Facial Spectrum Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

FACIAL SPECTRUM INC

Practice address

1208 NE Windsor Dr
Lees Summit, MO 64086-5594

Phone

(816) 524-4334

Fax

(816) 524-4399

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Steven J Prstojevich, MD DDSNPI 1588626659

Title

Owner/Surgeon

Phone

(816) 524-4334

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Steven J Prstojevich, MD DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lees Summit, MO
  • NPI 1588626659
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185840000000",
    "number": "1699861906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 NE WINDSOR DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865594",
            "telephone_number": "816-524-4334",
            "fax_number": "816-524-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 NE WINDSOR DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865594",
            "telephone_number": "816-524-4334",
            "fax_number": "816-524-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL SPECTRUM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-31",
        "status": "A",
        "authorized_official_last_name": "PRSTOJEVICH",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/SURGEON",
        "authorized_official_telephone_number": "816-524-4334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD DDS"
    },
    "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": []
}

• Eye Care, LLC
• Eyecare Specialties of Missouri LLC
• Eyemart Express LLC
• Jacob Eyler
• Susan Ezell, DO
• Shannon Fager, PHARMD
• Deidre L Fairall, LPC
• Jason Carter Fairman, PSY.D.
• Matthew Falke, MS, ATC, LAT
• Courtney Fall, LPC

• Oral and Maxillofacial Surgery (Dentist) in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.