NPIMap

Organization Active NPI

Facial and Oral Surgery Center LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bend, OR
National Provider Identifier
1801483318
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
FACIAL AND ORAL SURGERY CENTER LLC
Practice address
1893 NE Neff Rd
Bend, OR 97701-6112
Phone
(541) 382-7981
NPI assigned
Dec 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Authorized official

Name
Amir Azarisamani, MD, DMDNPI 1598021578
Title
President
Phone
(904) 993-3599

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

1893 NE Neff Rd
Bend, OR 97701-6112

Mailing address

1893 NE Neff Rd
Bend, OR 97701-6112
Phone (541) 382-7981

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL drschock.com

National Provider Directory

National Provider Directory

Locations

1893 NE Neff Rd
Bend, OR 97701
Phone (541) 382-1791

Practitioners & affiliated clinicians

Practitioners 3

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": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1801483318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016112",
            "telephone_number": "541-382-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 NE NEFF RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016112",
            "telephone_number": "541-382-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACIAL AND ORAL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "AZARISAMANI",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-993-3599",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drschock.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "1893 NE Neff Rd",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.