Scottsdale Facial & Oral Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SCOTTSDALE FACIAL & ORAL SURGERY LLC

Practice address

3501 N Scottsdale Rd Ste 226
Scottsdale, AZ 85251-5630

Phone

(480) 941-5005

Fax

(480) 946-0268

NPI assigned

Jan 15, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Kelli Jimenez

Title

Financial Coordinator

Phone

(480) 941-5005

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 4

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

• David Jonathan Haralson, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Surprise, AZ
  • NPI 1598988230
  NPD
• Tayler Faircloth

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Scottsdale, AZ
  • NPI 1083011316
  NPD (past)
• Derek H Lamb, DMD, MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Scottsdale, AZ
  • NPI 1063485829

  Oral and Maxillofacial Surgery

  NPD (past)
• George H Master, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Scottsdale, AZ
  • NPI 1871679019
  NPD (past)

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1861032005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD STE 226",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515630",
            "telephone_number": "480-941-5005",
            "fax_number": "480-946-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD STE 226",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515630",
            "telephone_number": "480-941-5005",
            "fax_number": "480-946-0268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE FACIAL & ORAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "480-941-5005",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Scottsdale",
            "affiliation": "N",
            "address_1": "3501 N Scottsdale Rd Ste 226",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852515630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Scottsdale Eye Surgery Center, P.C
• Scottsdale Facial Aesthetics PLLC
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• Scottsdale Family Dental P.L.L.C.
• Scottsdale Family Health, PLLC
• Scottsdale Family Physical Therapy, LLC

• Oral and Maxillofacial Surgery (Dentist) in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.