CREEKSIDE ORAL & FACIAL SURGERY INC (NPI# 1679943831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679943831 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE ORAL & FACIAL SURGERY INC |
| Other Organization Name | CREEKSIDE ORAL SURGERY |
| Practice Address |
7390 S Creek Rd Suite 101 Sandy UT 84093-6119 |
| Practice Telephone | 8012552422 |
| Practice Fax Number | 8012553013 |
| Mailing Telephone | 8012552422 |
| Mailing Fax Number | 8012553013 |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2016-06-30 |
| Authorized Official Name | DR. DAVID MAX ANDERSON (PRESIDENT) |
| Authorized Official Telephone | 8012552422 |
| Authorized Official Credential | DDS MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
315501-9924 | UT | Dental Providers |
| Other Name | Type Code |
|---|---|
| Creekside Oral Surgery | Other Name - Individual/Organization |
| Street Address |
7390 S CREEK RD SUITE 101 |
| City | SANDY |
| State | UT |
| Zip Code | 84093-6119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942830674 | Maren Vanwagoner Ferre | Nurse Practitioner | 1455 E Quail Stream Ln, Cottonwood Heights, UT 84093 | 2020-01-22 |
| 1154820041 | Cassandra Bringhurst | Music Therapist | 8261 S Viscounti Dr., Sandy, UT 84093 | 2018-02-06 |
| 1518480540 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 8645 S Highland Dr, Sandy, UT 84093 | 2017-07-21 |
| 1457881955 | Valor Psychological Services, LLC | Psychologist | 8160 S Highland Dr Ste C104, Sandy, UT 84093 | 2017-06-16 |
| 1700279197 | Russell G. Lewis | Dentist | 1434 E. 9400 S. Ste 201, Sandy, UT 84093 | 2015-03-10 |
| 1568771350 | Susan Lynn Nikola | Pharmacist | 8745 S. Highland Dr, Sandy, UT 84093 | 2010-09-28 |
| 1659696227 | Pamela Elizabeth Boyleston | Nurse Anesthetist, Certified Registered | 2628 Partridge Way, Sandy, UT 84093 | 2010-04-07 |
| 1700025582 | Kirk Madson Neuberger | Surgery | 9181 Wedgefield Dr., Sandy, UT 84093 | 2009-02-18 |
| 1326230392 | Sunrie Sandy Senior Living LLC | Assisted Living Facility | 2101 E 9400 S, Sandy, TN 84093 | 2007-08-14 |
| 1497870588 | Chandra Lee Roberson | Counselor | 8188 So. Highland Drive, Suite D-4, Sandy, UT 84093 | 2007-03-20 |
| Find all providers in zip 84093 | ||||
| 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 |
|---|---|---|---|---|
| 1568974434 | Utah Wisdom Teeth, LLC | Dentist | 1030 E 11400 S Ste 2a, Sandy, UT 84094-6906 | 2017-10-31 |
| 1447623830 | Great Smiles Dental Clinic LLC | Dentist | 7410 S Creek Rd, #303, Sandy, UT 84093-6140 | 2015-11-06 |
| 1225231962 | Steven Gerald Graff | Dentist | 870 East 9400 South, Suite 106, Sandy, UT 84094-3684 | 2007-06-08 |
| 1689793994 | Patrick Brain | Dentist | 11400 South 1030 East, Suite C, Sandy, UT 84094 | 2007-03-28 |
| 1619061546 | David M Anderson | Dentist | 7390 Creek Rd Ste 101, Sandy, UT 84093-6121 | 2006-10-03 |
| 1689781189 | Creed S Haymond | Dentist | 1434 E 9400 S, Ste 102, Sandy, UT 84093 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394631 | Vineyard Oral and Maxillofacial Surgery | Dentist | 707 E Mill Rd Ste 102, Vineyard, UT 84059-5732 | 2020-10-22 |
| 1306489059 | Alpine Dentists and Specialists Pllc | Dentist | 20 W Main Street Ct Ste 100, Alpine, UT 84004-1889 | 2019-10-25 |
| 1194213074 | Lehi Oral Surgery PC | Dentist | 2961 W Maple Loop Dr Ste 130, Lehi, UT 84043-5717 | 2018-04-26 |
| 1346629441 | Eric Wood | Dentist | 3610 N University Ave Ste 150, Provo, UT 84604-4444 | 2015-05-21 |
| 1023336104 | Adam C Stanley | Dentist | 3632 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7163 | 2010-05-13 |
| 1790012243 | Southern Utah Surgical Arts | Dentist | 393 E Riverside Dr Bldg 2, Suite 2b, St George, UT 84790-7065 | 2009-11-04 |
| 1487887204 | Joseph Fullmer | Dentist | 493 S Main St # 200, Heber City, UT 84032-2240 | 2009-08-27 |
| 1407085160 | Davis Center for Oral & Maxillofacial Surgery | Dentist | 890 Heritage Park Blvd Ste 103, Layton, UT 84041-5622 | 2009-07-02 |
| 1144456542 | Adam Patrick Mccormick | Dentist | 2297 N Hill Field Rd Ste 105, Layton, UT 84041-6928 | 2009-06-01 |
| 1780821124 | Oral and Maxillofacial Surgeons of Utah, LLC | Dentist | 2297 N Hillfield Rd, Building A, Suite 105, Layton, UT 84041-6928 | 2009-01-07 |
| 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.