NPIMap

Organization Active NPI

Premiere Maxillofacial Surgeons, Inc.

  • General Practice Dentistry
  • Eureka, CA
National Provider Identifier
1851411367
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52119 Issued in CA
Legal business name
PREMIERE MAXILLOFACIAL SURGEONS, INC.
Practice address
3132 Harrison Ave
Eureka, CA 95503-5638
Phone
(707) 442-1775
Fax
(707) 444-2821
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Authorized official

Name
Dr. William H Tetteh-Martey, DMDNPI 1366655987
Title
President
Phone
(626) 665-9279

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 52119 CA Primary

Addresses

Primary practice location

3132 Harrison Ave
Eureka, CA 95503-5638

Mailing address

3132 Harrison Ave
Eureka, CA 95503-5638
Phone (707) 442-1775

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447718400000",
    "number": "1851411367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955035638",
            "telephone_number": "707-442-1775",
            "fax_number": "707-444-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 HARRISON AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955035638",
            "telephone_number": "707-442-1775",
            "fax_number": "707-444-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE MAXILLOFACIAL SURGEONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-11-17",
        "status": "A",
        "authorized_official_last_name": "TETTEH-MARTEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-665-9279",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.