Arizona Oral Facial and Implant Surgery LLC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

31035 Issued in AZ

Legal business name

ARIZONA ORAL FACIAL AND IMPLANT SURGERY LLC

Practice address

2450 W Ray Rd Ste 1
Chandler, AZ 85224-3595

Phone

(480) 814-9500

Fax

(480) 814-9501

NPI assigned

Feb 29, 2008

Last updated

Mar 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cecilia Ruebush

Title

Accounts Manager

Phone

(480) 814-9500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1982873311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W RAY RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243595",
            "telephone_number": "480-814-9500",
            "fax_number": "480-814-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 W RAY RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243595",
            "telephone_number": "480-814-9500",
            "fax_number": "480-814-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA ORAL FACIAL AND IMPLANT SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "RUEBUSH",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "480-814-9500"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "31035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "786600",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.