ORAL AND MAXILLOFACIAL SURGEONS OF NORTHERN ARIZONA (NPI# 1487651071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487651071 |
| Entity Type | Organization |
| Organization Name | ORAL AND MAXILLOFACIAL SURGEONS OF NORTHERN ARIZONA |
| Practice Address |
77 W Forest Ave Ste 107 Flagstaff AZ 86001-1482 |
| Practice Telephone | 9287732530 |
| Practice Fax Number | 9287732532 |
| Mailing Telephone | 9287732530 |
| Mailing Fax Number | 9287732532 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2007-10-16 |
| Authorized Official Name | LORIN DEAN PETERSON (PRESIDENT) |
| Authorized Official Telephone | 9287732530 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
2803 | AZ | Dental Providers |
| Street Address |
77 W FOREST AVE STE 107 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1482 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235133059 | Gretchen Karr Schaber | Nurse Practitioner | 77 W Forest Ave, Ste 302, Flagstaff, AZ 86001-1481 | 2005-06-09 |
| 1740728088 | Susan Dale Wall | Social Worker | 77 W Forest Ave, Suite 202, Flagstaff, AZ 86001-1479 | 2017-02-07 |
| 1326408527 | Taye Nelson | Nurse Practitioner | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2016-03-01 |
| 1639564453 | Mary Elizabeth Smith Iles | Pediatrics | 77 W Forest Ave, Flagstaff, AZ 86001 | 2015-03-30 |
| 1174914915 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2015-02-16 |
| 1699182188 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2014-07-16 |
| 1033538533 | Neina Orrillo | Registered Nurse | 77 W Forest Ave, Suite 207, Flagstaff, AZ 86001 | 2014-04-11 |
| 1720424997 | Meredith Katz Sena | Specialist | 77 W Forest Ave, Ste 301, Flagstaff, AZ 86001-1479 | 2013-05-15 |
| 1669815825 | Lauren Diane Hayward | Pediatrics | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2013-04-08 |
| 1548510019 | Mark Daniel Noorlander | Nurse Anesthetist, Certified Registered | 77 W Forest Ave, Suite 207, Flagstaff, AZ 86001-1479 | 2012-09-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699772061 | Lorin Dean Peterson | Dentist | 77 W Forest Ave, Ste 107, Flagstaff, AZ 86001-1482 | 2005-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538374269 | Wayne G. Thorpe, Dds | Dentist | 3329 E Baseline Rd, Gilbert, AZ 85234-2633 | 2007-05-14 |
| 1790838605 | Donald R. Hoaglin | Dentist | 18301 N 79th Ave Ste G185, Glendale, AZ 85308-6093 | 2007-01-22 |
| 1467548560 | David P Griffith | Dentist | 6535 W. Camelback Road, Suite 3, Phoenix, AZ 85033 | 2006-10-05 |
| 1770140691 | Belma Maruflu Dds PC | Dentist | 3976 N Campbell Ave, Tucson, AZ 85719-1460 | 2019-05-27 |
| 1871018887 | Summit Dental Specialty Pllc | Dentist | 15810 S 45th St Ste 120, Phoenix, AZ 85048-7695 | 2017-08-10 |
| 1356570824 | Matthew Clifton Hanchett | Dentist | 2680 S Val Vista Dr Ste 164, Gilbert, AZ 85295-1638 | 2009-07-06 |
| 1023166360 | Arrowhead Oral & Maxillofacial Surgery | Dentist | 18555 N 79th Ave, #a103, Glendale, AZ 85308-8370 | 2007-01-05 |
| 1265519417 | Christopher A. Lines | Dentist | 2415 S Rural Rd, #b, Tempe, AZ 85282-2440 | 2006-11-01 |
| 1235247651 | Wayne G. Thorpe | Dentist | 3329 E Baseline Rd, Gilbert, AZ 85234-2633 | 2006-08-27 |
| 1326082587 | Eric Roy Engel | Dentist | 3800 W Ray Rd, #14, Chandler, AZ 85226-5940 | 2006-06-16 |
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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.