Facial Oral and Dental Implant Surgery Associates, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

FACIAL ORAL AND DENTAL IMPLANT SURGERY ASSOCIATES, INC.

Practice address

1256 SE Bishop Blvd
Suite I
Pullman, WA 99163-5414

Phone

(509) 330-5020

NPI assigned

Sep 27, 2016

Organization subpart

No

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

Authorized official

Name

Stephen W Holm, DMDNPI 1295993145

Title

Owner

Phone

(509) 330-5020

Specialties & licenses 1

Addresses

Tax ID family

Facial Oral and Dental Implant Surgery Associates Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Facial Oral and Dental Implant Surgery Associates, Inc.

  dba Oral and Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Lewiston, ID
  • NPI 1003060591
  NPD tax ID

Locations

Practitioners 1

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

• Stephen W Holm, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Lewiston, ID
  • NPI 1295993145
  NPD (past) Authorized official

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1730638180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 SE BISHOP BLVD",
            "address_2": "SUITE I",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635414",
            "telephone_number": "509-330-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 SE BISHOP BLVD",
            "address_2": "SUITE I",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635414",
            "telephone_number": "509-330-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL ORAL AND DENTAL IMPLANT SURGERY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-330-5020",
        "authorized_official_credential": "DMD"
    },
    "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": []
}

• Kathleen Joy Evermann, LICSW
• Eye and Wellness, LLC
• Eye Care Specialists PS (Eye Care Optical)
• Eye Care Specialists PS (The Laser and Surgery Center)
• Eye Care Specialists PS (The Laser and Surgery Center)
• Fahari Adult Family Home LLC
• Jonathan M. Fairbanks, DDS
• Family Home Care Corporation (Family Home Care and Hospice)
• Loralee Farrer, MS, CCC-SLP
• Linda Fearn, MD

• Oral and Maxillofacial Surgery (Dentist) in Pullman, WA
• Providers in Pullman, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.