IMPLANT&MAXILLOFACIAL SURGICAL CENTER (NPI# 1255759650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255759650 |
| Entity Type | Organization |
| Organization Name | IMPLANT&MAXILLOFACIAL SURGICAL CENTER |
| Practice Address |
2224 1st Ave W Ste 2 Williston ND 58801-6286 |
| Practice Telephone | 7017215254 |
| Mailing Telephone | 7017215254 |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-02 |
| Authorized Official Name | DR. JUAN J. ULLOA (ORAL&MAXILLOFACIAL SURGEON/OWNER) |
| Authorized Official Telephone | 7017215254 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1993 | ND | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PERSONAL NPI | 1811196504 | 01 |
| Street Address |
2224 1ST AVE W STE 2 |
| City | WILLISTON |
| State | ND |
| Zip Code | 58801-6286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952868556 | Purpose Driven Interventions | Counselor | 1502 13th Ave West, Williston, ND 58801 | 2019-03-01 |
| 1437637501 | Camille Ann Settelmeyer | Nurse Practitioner | 1213 15th Avenue West, Williston, ND 58801 | 2018-08-01 |
| 1801317417 | Shelby Laine Carlson | Physical Therapist | 1502 13th Ave W Suite 101, Williston, ND 58801 | 2017-07-05 |
| 1710418579 | Catrina Louise Lindvig | Chiropractor | 1135 2nd Ave W Ste 203, Williston, ND 58801 | 2017-03-23 |
| 1801337415 | Selah Counseling | Clinic/Center | 125 Main St, Suite #220, Williston, ND 58801 | 2017-03-15 |
| 1316485634 | Theresa E Scully | Social Worker | 125 Main St; Unit 220, Williston, ND 58801 | 2017-02-07 |
| 1346792256 | Donna Peterson | Social Worker | 1500 14th St Sw, Suite 250, Williston, ND 58801 | 2016-10-26 |
| 1730509084 | Lacey Thompson | Case Manager/Care Coordinator | 110 West Broadway, Suite 202, Williston, ND 58801 | 2014-04-24 |
| 1770904708 | Kayla Jo Rossland | Physical Therapist | 221 University Ave Ste 203, Williston, ND 58801 | 2013-12-17 |
| 1285072710 | Susan Mae Bradford | Counselor | 612 4th St. E., Williston, ND 58801 | 2013-06-06 |
| Find all providers in zip 58801 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598816076 | Robert F. Nolan | Dentist | 2224 1st Ave W, Williston, ND 58801-6286 | 2007-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343737 | Face and Jaw Surgeons PC | Dentist | 1517 12 Ave Ne, Jamestown, ND 58401 | 2020-10-16 |
| 1649816828 | Dr. Jeremiah J. Glosenger, PC | Dentist | 2615 Elk Dr Ste 3, Minot, ND 58701-1200 | 2019-11-21 |
| 1477723591 | Oral Surgery Center of Bismarck, PC | Dentist | 3117 N 14th St, Bismarck, ND 58503-0664 | 2008-03-04 |
| 1457420564 | Face and Jaw Surgeons PC | Dentist | 2845 36 Ave South, Grand Forks, ND 58201-6747 | 2006-11-06 |
| 1073697157 | Troy R Petersen | Dentist | 1165c South Columbia Road, Grand Forks, ND 58201-4007 | 2006-10-25 |
| 1790889152 | Rudy J Schneider | Dentist | 3187 Blue Stem Dr Ste 4, West Fargo, ND 58078-8008 | 2006-09-07 |
| 1588697015 | Phillip T. Iero, M.d.,d.d.s., PC | Dentist | 416 N 6th St, Bismarck, ND 58501-4416 | 2006-07-08 |
| 1285670067 | John G Stanley | Dentist | 2331 Tyler Pkwy, Suite 4, Bismarck, ND 58503-0871 | 2006-06-21 |
| 1184667305 | Face and Jaw Surgeons PC | Dentist | 1140 W Capitol Ave, Bismarck, ND 58501-9956 | 2006-06-14 |
| 1003859117 | Joseph Richard Deatherage | Dentist | 1730 Burnt Boat Dr Ste 300, Bismarck, ND 58503-0886 | 2006-06-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.