Intermountain Oral & Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

LIC-4-12-7785 Issued in UT

Legal business name

INTERMOUNTAIN ORAL & MAXILLOFACIAL SURGERY

Practice address

6287 S Redwood Rd
#103
Taylorsville, UT 84123-6634

Phone

(801) 261-2444

NPI assigned

Jun 19, 2012

Last updated

Jun 19, 2012By 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. Mark Ryser, DMDNPI 1942321518

Title

Oral Surgeon

Phone

(801) 261-2444

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Mark Ralph Ryser, D.M.D., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Taylorsville, UT
  • NPI 1942321518
  Authorized official Same address or phone

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1760745251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6287 S REDWOOD RD",
            "address_2": "#103",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841236634",
            "telephone_number": "801-261-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6287 S REDWOOD RD",
            "address_2": "#103",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841236634",
            "telephone_number": "801-261-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "RYSER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "801-261-2444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "LIC-4-12-7785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camilla Ingraham
• Kara Ingraham
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• Intermountain Community Supports and Services, LLC (Icss)
• Intermountain Healthcare
• Intermountain Pain Management and Injury, Inc, (Intermountain Pain and Injury)
• Intermountain Pain Solutions
• Interventional Medical Center
• Intuitive Therapy PLLC
• Caleb Isaacson

• Oral and Maxillofacial Surgery (Dentist) in Taylorsville, UT
• Providers in Taylorsville, 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 19, 2012; 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.