NPIMap

Individual provider Active NPI

David Russell Adams, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Fresno, CA
National Provider Identifier
1831282755
Registry record updated Oct 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
24264 Issued in CA
Practice address
1111 E Herndon Ave Ste 119
Fresno, CA 93720-3100
Phone
(559) 431-4220
Fax
(559) 431-9276
NPI assigned
Oct 2, 2006
Last updated
Oct 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 24264 CA Primary

Addresses

Primary practice location

1111 E Herndon Ave Ste 119
Fresno, CA 93720-3100

Mailing address

1111 E Herndon Ave Ste 119
Fresno, CA 93720-3100
Phone (559) 431-4220

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dadams238220@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200812002269 UT Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 2961576079 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

520 S Wakara Way
Salt Lake City, UT 84108-1213
Phone (801) 587-9161

530 S Wakara Way
Salt Lake City, UT 84108-1213
Phone (801) 587-6453

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24264CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince May 8, 2020 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Dental Services CurrentSince May 8, 2020 Accepting new patients
University of Utah Dental Services Current Accepting new patients
University of Utah Adult Services CurrentSince May 8, 2020 Accepting new patients
University of Utah Dental Services CurrentSince May 8, 2020 Accepting new patients
Andrew R. Rahn, DDS, PC Oral and Maxillofacial Surgery PastSince May 7, 2018 Accepting new patients
Ann Marie Grady, D.D.S., PC Past Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
Scott J. Fimbres, D.D.S., Inc. Oral and Maxillofacial Surgery Past Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

530 S Wakara Way
Slc, UT 84108
Phone (801) 581-8951

Interoperability endpoints

  • Direct secure messaging: dadams238220@direct.med.utah.edu

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634342400000",
    "number": "1831282755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E HERNDON AVE STE 119",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203100",
            "telephone_number": "559-431-4220",
            "fax_number": "559-431-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E HERNDON AVE STE 119",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203100",
            "telephone_number": "559-431-4220",
            "fax_number": "559-431-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "DAVID",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-10-16",
        "certification_date": "2021-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "24264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dadams238220@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.