NPIMap

Organization Active NPI

Desert Valley Oral Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Gilbert, AZ
National Provider Identifier
1881189199
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
D08601 Issued in AZ
Legal business name
DESERT VALLEY ORAL SURGERY
Practice address
2915 E. Baseline Road
Suite 106
Gilbert, AZ 85234
Phone
(480) 539-6420
Fax
(480) 663-6370
NPI assigned
Jun 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Dr. Donovan R. Hansen, D.D.S.NPI 1700020146
Title
Owner
Phone
(480) 539-6420

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
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X D08601 AZ Primary

Addresses

Primary practice location

2915 E. Baseline Road
Suite 106
Gilbert, AZ 85234

Mailing address

2915 E. Baseline Road
Suite 106
Gilbert, AZ 85234
Phone (480) 539-6420

National Provider Directory

National Provider Directory

Locations

2915 E Baseline Rd
Ste 106
Gilbert, AZ 85234
Phone (480) 539-6420

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": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1881189199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 E. BASELINE ROAD",
            "address_2": "SUITE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-539-6420",
            "fax_number": "480-663-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 E. BASELINE ROAD",
            "address_2": "SUITE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-539-6420",
            "fax_number": "480-663-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT VALLEY ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-539-6420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "D08601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.