SAN TAN VALLEY ORAL FACIAL AND IMPLANT SURGERY PLLC (NPI# 1629546171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629546171 |
| Entity Type | Organization |
| Organization Name | SAN TAN VALLEY ORAL FACIAL AND IMPLANT SURGERY PLLC |
| Practice Address |
36327 N Gantzel Rd Suite 102 San Tan Valley AZ 85140 |
| Mailing Address |
2450 W Ray Rd Ste 1 Chandler AZ 85224-3595 |
| Practice Telephone | 4808149500 |
| Practice Fax Number | 5202100442 |
| Mailing Telephone | 4808149500 |
| Mailing Fax Number | 4808149501 |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2018-11-02 |
| Authorized Official Name | NISHITH S SHAH (DOCTOR/OWNER) |
| Authorized Official Telephone | 4808149500 |
| Authorized Official Credential | D.M.D., M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
36327 N GANTZEL RD SUITE 102 |
| City | SAN TAN VALLEY |
| State | AZ |
| Zip Code | 85140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801429634 | Bhsm Rehabilitation, LLC | Clinic/Center | 37200 North Gantzel Road, Suite 260, Queen Creek, AZ 85140 | 2020-02-20 |
| 1801455712 | Jose Enrique Knox | Specialist/Technologist, Other | 36018 North Secret Garden Path, Queen Creek, AZ 85140 | 2019-06-13 |
| 1780164582 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 40950 N Ironwood Dr, Queen Creek, AZ 85140 | 2018-08-21 |
| 1497249452 | San Tan Primary Care PC | Family Medicine | 36283 N Gantzel Rd Ste 101, San Tan Valley, AZ 85140 | 2018-06-21 |
| 1306386115 | Veronica Gonzalez | Licensed Practical Nurse | 733 E Angeline Ave, Queen Creek, AZ 85140 | 2017-02-27 |
| 1194198697 | Amanda Ellis | Residential Treatment Facility, Physical Disabilities | 381 East Brook Street, San Tan Valley, AZ 85140 | 2015-11-05 |
| 1043688336 | Felicia D Adams | Day Training/Habilitation Specialist | 1074 E. Press Rd, San Tan Valley, AZ 85140 | 2015-09-03 |
| 1376928598 | Amy Burks | Physical Therapy Assistant | 1479 E Oak Rd, San Tan Valley, AZ 85140 | 2015-07-29 |
| 1316367121 | Shanaya Suchak | Internal Medicine | 37000 N Gantzel Road, Attn: Hospitalists, San Tan Valley, AZ 85140 | 2014-04-19 |
| 1407296023 | Devin G Anderson | Audiologist | 36305 N Gantzel Rd Ste 104, San Tan Valley, AZ 85140 | 2013-06-27 |
| Find all providers in zip 85140 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881189199 | Desert Valley Oral Surgery | Oral & Maxillofacial Surgery | 2915 E. Baseline Road, Suite 106, Gilbert, AZ 85234 | 2018-06-28 |
| 1982873311 | Arizona Oral Facial and Implant Surgery LLC | Oral & Maxillofacial Surgery | 2450 W Ray Rd Ste 1, Chandler, AZ 85224-3595 | 2008-02-29 |
| 1538358189 | Mark D. Pogue, M.d. D.d.s., P.C. | Oral & Maxillofacial Surgery | 8535 E Hartford Dr Ste 100, Scottsdale, AZ 85255-5443 | 2007-10-19 |
| 1114125267 | Associates In Oral and Maxillofacial Surgery Pllc | Oral & Maxillofacial Surgery | 3150 N Swan, Tucson, AZ 85712 | 2007-07-10 |
| 1861528465 | Sabah Kalamchi | Oral & Maxillofacial Surgery | 8112 N 87th Pl, Scottsdale, AZ 85258-4335 | 2007-02-26 |
| 1710025044 | Angelle M Casagrande | Oral & Maxillofacial Surgery | 3150 N Swan Road, Tucson, AZ 85712 | 2007-02-01 |
| 1619026564 | Woodlands Oral & Maxillofacial Surgery PC | Oral & Maxillofacial Surgery | 1635 S Plaza Way, Flagstaff, AZ 86001-7102 | 2007-01-09 |
| 1114940335 | Nish S Shah | Oral & Maxillofacial Surgery | 2450 W Ray Rd, Ste 1, Chandler, AZ 85224 | 2006-07-26 |
| 1255327169 | Mark Pogue | Oral & Maxillofacial Surgery | 8535 E Hartford Dr, Scottsdale, AZ 85255-5438 | 2005-09-26 |
| 1235134503 | Daniel James Klemmedson | Oral & Maxillofacial Surgery | 3150 N Swan Rd, Tucson, AZ 85712-1227 | 2005-06-14 |
| Find all providers with the same taxonomy | ||||
| City | SAN TAN VALLEY |
| Zip Code | 85140 |
Please comment or provide details below to improve the information on SAN TAN VALLEY ORAL FACIAL AND IMPLANT SURGERY PLLC.
| 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.