Oragen in-House Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

ORAGEN IN-HOUSE SURGERY LLC

Practice address

11996 S Anthem Park Blvd # 100
Herriman, UT 84096-5643

Phone

(801) 448-0366

NPI assigned

Apr 2, 2024

Organization subpart

No

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

Authorized official

Name

Whitney Pavick

Title

Director of Operations

Phone

(802) 857-7947

Specialties & licenses 1

Addresses

Other names 1

• In-House Oral Surgery Doing business as

Locations

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1831941095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 285",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840140285",
            "telephone_number": "801-448-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11996 S ANTHEM PARK BLVD # 100",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840965643",
            "telephone_number": "801-448-0366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4575 Midland Dr",
            "address_purpose": "LOCATION",
            "city": "West Haven",
            "state": "UT",
            "postal_code": "844013824",
            "country_code": "US",
            "telephone_number": "385-390-0140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "991 Shepard Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "UT",
            "postal_code": "840252973",
            "country_code": "US",
            "telephone_number": "385-390-0140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3535 S Market St Ste 145",
            "address_purpose": "LOCATION",
            "city": "West Valley City",
            "state": "UT",
            "postal_code": "841193637",
            "country_code": "US",
            "telephone_number": "385-390-0140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13957 S Bangerter Pkwy",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840205429",
            "country_code": "US",
            "telephone_number": "801-448-0366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORAGEN IN-HOUSE SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "PAVICK",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "802-857-7947"
    },
    "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": [
        {
            "organization_name": "In-House Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Herriman, UT
• Providers in Herriman, 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 Apr 2, 2024; 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.