ORAL SURGERY SPECIALTY (NPI# 1790089886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790089886 |
| Entity Type | Organization |
| Organization Name | ORAL SURGERY SPECIALTY |
| Practice Address |
3648 W 9800 S South Jordan UT 84095-3260 |
| Mailing Address |
Po Box 367 Draper UT 84020-0367 |
| Practice Telephone | 8013972727 |
| Mailing Telephone | 8013972727 |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2011-11-22 |
| Authorized Official Name | DR. L. DOUGLAS ISRAELSEN (OWNER) |
| Authorized Official Telephone | 8013972727 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 135181 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
3648 W 9800 S |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095-3260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758283 | Menakhem Davidov | Dentist | 3648 W 9800 S, South Jordan, UT 84009-3260 | 2019-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033745393 | Beverly Laraine Williams | Social Worker | 11260 S River Heights Drive, South Jordan, UT 84095 | 2020-03-19 |
| 1265902902 | Sarah Richele Kelley | Specialist/Technologist | 10236 Alder Grovey Way, South Jordan, UT 84095 | 2018-11-26 |
| 1326528837 | Kristi Couse | Massage Therapist | 10679 S 2200 W Apt 2, South Jordan, UT 84095 | 2018-08-15 |
| 1821516063 | River Crossing Dental Professional Corporation | Clinic/Center | 12427 South 4000 West, Suite #200, Riverton, UT 84095 | 2017-09-08 |
| 1245755719 | Staci Stout | Dental Hygienist | 3113 W Swiss Pass Cir, South Jordan, UT 84095 | 2017-08-07 |
| 1437698750 | Ryan Sears | Dentist | 10894 So. River Front Parkway, South Jordan, UT 84095 | 2017-02-20 |
| 1366989931 | Ultimate Sports Regenerative Medicine | Chiropractor | 1098 W. South Jordan Pkwy, Suite 101, South Jordan, UT 84095 | 2017-01-20 |
| 1306393889 | Tal Quirl | Optometrist | 3571 W. 10400 S., South Jordan, UT 84095 | 2016-09-01 |
| 1023562667 | Sevon Taroian | Social Worker | 11260 River Heights Drive, South Jordan, UT 84095 | 2016-08-11 |
| 1952762932 | Megan Buckley | Developmental Therapist | 881 Baxter Drive, Ste 100, South Jordan, UT 84095 | 2016-03-17 |
| Find all providers in zip 84095 | ||||
| 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 |
|---|---|---|---|---|
| 1962918094 | Southern Utah Surgical Arts | Oral & Maxillofacial Surgery | 393 E Riverside Dr, Ste 2b, St. George, UT 84790 | 2017-12-27 |
| 1245601012 | Oral & Maxillofacial Surgeons of Utah | Oral & Maxillofacial Surgery | 2297 N Hill Field Rd, Suite 105, Layton, UT 84041-6920 | 2015-10-19 |
| 1275899809 | Utah Oral Surgery & Dental Implant Center | Oral & Maxillofacial Surgery | 6243 S Redwood Rd Ste 100, Salt Lake City, UT 84123-6408 | 2012-04-09 |
| 1851528244 | Matthew N Maxfield | Oral & Maxillofacial Surgery | 6710 S Blackstone Rd, Ste 104, Salt Lake City, UT 84121-6232 | 2009-06-12 |
| 1619192424 | Gregory Earl Anderson | Oral & Maxillofacial Surgery | 1395 No. 400 E., Ste B, Logan, UT 84341 | 2007-04-16 |
| 1689795114 | Alvin J Stosich | Oral & Maxillofacial Surgery | 6268 S 900 E, Ste 100, Salt Lake City, UT 84121-2497 | 2007-04-02 |
| 1376607721 | Steven E Christensen | Oral & Maxillofacial Surgery | 6243 South Redwood Rd, Suite 100, Salt Lake City, UT 84123 | 2006-12-20 |
| 1548320963 | Michael S Wilkinson | Oral & Maxillofacial Surgery | 1320 N 600 E, Suite 3, Logan, UT 84341-2431 | 2006-12-08 |
| 1174604128 | Nathan G Adams | Oral & Maxillofacial Surgery | 3920 S 1100 E Ste 150, Salt Lake City, UT 84124-1266 | 2006-10-18 |
| 1215038740 | James H Barton | Oral & Maxillofacial Surgery | 882 N Main St, Richfield, UT 84701-1840 | 2006-09-26 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH JORDAN |
| Zip Code | 84095 |
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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.