Kalispell Oral Surgery Center LLC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

KALISPELL ORAL SURGERY CENTER LLC

Practice address

180 Timberwolf Pkwy
Kalispell, MT 59901-1218

Phone

(406) 755-6014

Fax

(406) 755-6094

NPI assigned

Aug 10, 2021

Last updated

Aug 10, 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. Joshua Blanton-Dickens, DMDNPI 1063875946

Title

Member

Phone

(406) 755-6014

Specialties & licenses 3

Addresses

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.

• Joshua Blanton-Dickens, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Kalispell, MT
  • NPI 1063875946
  Authorized official Same address or phone
• Casey Russell Shepherd, DMD MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Kalispell, MT
  • NPI 1720305741

  Oral and Maxillofacial Surgery

  NPD

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1710652938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 TIMBERWOLF PKWY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011218",
            "telephone_number": "406-755-6014",
            "fax_number": "406-755-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 TIMBERWOLF PKWY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011218",
            "telephone_number": "406-755-6014",
            "fax_number": "406-755-6094"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 13th St E Ste 101",
            "address_purpose": "LOCATION",
            "city": "Whitefish",
            "state": "MT",
            "postal_code": "599372966",
            "country_code": "US",
            "telephone_number": "406-755-6014",
            "fax_number": "406-755-6094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KALISPELL ORAL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "BLANTON-DICKENS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "406-755-6014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalispell Medical Offices
• Kalispell Medical Oncology, PLLP
• Kalispell Midwives & Womens Health Inc
• Kalispell Obstetrics & Gynecology PLLC
• Kalispell Optometry PLLC
• Kalispell Public Schools
• Kalispell Reginal Medical Center (The Clinic at Wal-Mart by KRMC)
• Kalispell Regional Healthcare
• Kalispell Regional Med Center Inc (Logan Health Wound Care)
• Kalispell Regional Med Center Inc (Kalispell Gastroenterology)

• Oral & Maxillofacial Surgery (D.M.D.) in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.