Southwest Oral and Facial Surgery Inc

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

355097-9924 Issued in UT

Legal business name

SOUTHWEST ORAL AND FACIAL SURGERY INC

Practice address

11748 S 3600 W
Suite 1
South Jordan, UT 84095-5922

Phone

(801) 938-3412

Fax

(801) 938-3413

NPI assigned

May 29, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Jared Mathew Brown, D.D.S, M.DNPI 1326167354

Title

Owner/Surgeon

Phone

(801) 938-3412

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Jared M Brown, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • South Jordan, UT
  • NPI 1326167354
  NPD (past) Authorized official
• Eric Wood, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Provo, UT
  • NPI 1346629441
  NPD (past)

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1821400532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11748 S 3600 W",
            "address_2": "SUITE 1",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955922",
            "telephone_number": "801-938-3412",
            "fax_number": "801-938-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11748 S 3600 W",
            "address_2": "SUITE 1",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955922",
            "telephone_number": "801-938-3412",
            "fax_number": "801-938-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST ORAL AND FACIAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER/SURGEON",
        "authorized_official_telephone_number": "801-938-3412",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S, M.D"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "355097-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery Clinic/Center in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; 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.