NPIMap

Organization Active NPI

Southern Utah Surgical Arts

Doing business as Oral & Facial Surgery Institute

  • Oral & Maxillofacial Surgery (D.M.D.)
  • St George, UT
National Provider Identifier
1962918094
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
6524667 Issued in UT
Legal business name
SOUTHERN UTAH SURGICAL ARTS
Doing business as
Oral & Facial Surgery Institute
Practice address
393 E Riverside Dr, Ste 2B
St. George, UT 84790
Phone
(435) 628-1100
Fax
(435) 673-0330
NPI assigned
Dec 27, 2017
Last updated
Dec 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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

Authorized official

Name
Dr. Shawn B Davis, DMDNPI 1518000421
Title
Owner
Phone
(435) 628-1100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X D07932 AZ
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 6524667 UT Primary

Addresses

Primary practice location

393 E Riverside Dr, Ste 2B
St. George, UT 84790

Mailing address

393 E Riverside Dr, Ste 2B
St George, UT 84790
Phone (435) 628-1100

Other names 1

  • Oral & Facial Surgery Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Oral Facial Surgery Institute2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514332800000",
    "number": "1962918094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E RIVERSIDE DR, STE 2B",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-628-1100",
            "fax_number": "435-673-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E RIVERSIDE DR, STE 2B",
            "city": "ST. GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-628-1100",
            "fax_number": "435-673-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN UTAH SURGICAL ARTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-27",
        "last_updated": "2017-12-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-628-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "D07932",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "UT",
            "license": "6524667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oral & Facial Surgery Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; 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.