ORAL AND FACIAL SURGERY CENTER OF PRESCOTT (NPI# 1275925265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275925265 |
| Entity Type | Organization |
| Organization Name | ORAL AND FACIAL SURGERY CENTER OF PRESCOTT |
| Practice Address |
5415 Distiction Way Prescott AZ 86301 |
| Practice Telephone | 2054700047 |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2015-07-23 |
| Authorized Official Name | BENJAMIN ABT (OWNER/PROVIDER) |
| Authorized Official Telephone | 2054700047 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
8911 | AZ | Dental Providers |
| Street Address |
5415 DISTICTION WAY |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1841680121 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 3911 Hwy 69, Prescott, AZ 86301 | 2015-01-26 |
| Find all providers in zip 86301 | ||||
| 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 |
|---|---|---|---|---|
| 1568697654 | Benjamin Robert Abt | Dentist | 5415 Distinction Way, Prescott, AZ 86301-8438 | 2009-05-19 |
| 1346347234 | Kevin Vincent Rethman | Dentist | 1747 Willow Creek Rd, Prescott, AZ 86301-1154 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255945366 | Phoenix Wisdom Teeth, LLC | Dentist | 17037 N 43rd Ave # A4a, Glendale, AZ 85308-4026 | 2020-09-04 |
| 1962052035 | Summit Aesthetics LLC | Dentist | 34209 N. Scottsdale Rd, Suite 103, Scottsdale, AZ 85266 | 2019-09-19 |
| 1497317275 | Sandstone Oral Maxillofacial Surgery Pllc | Dentist | 20755 W Mcdowell Rd # 111, Buckeye, AZ 85396-2070 | 2019-07-02 |
| 1790254183 | Delsnyder Dental Corp | Dentist | 995 E Baseline Rd Apt 1172, Tempe, AZ 85283-1354 | 2018-11-15 |
| 1346717246 | Robison Orthodontics LLC | Dentist | 1355 S Higley Rd # 105, Gilbert, AZ 85296 | 2018-10-29 |
| 1932674108 | A. W. Ray Dds Md LLC | Dentist | 928 W Chandler Blvd Ste D-2, Chandler, AZ 85225-4900 | 2018-10-03 |
| 1457844516 | Chandler Oral and Maxillofacial Surgery | Dentist | 1799 E Queen Creek Rd Ste 4, Chandler, AZ 85286-2015 | 2018-06-12 |
| 1730681776 | Phoenix Oral and Maxillofacial Surgeons | Dentist | 9515 W Camelback Rd Ste 122, Phoenix, AZ 85037-1365 | 2018-03-06 |
| 1861993040 | Joseph E. Pierse, Dmd, Pllc | Dentist | 2060 W Whispering Wind Dr Ste 167, Phoenix, AZ 85085-2869 | 2018-02-23 |
| 1477075653 | Bertz Professional Corporation | Dentist | 3501 N Scottsdale Rd Ste 110, Scottsdale, AZ 85251-5649 | 2017-07-10 |
| 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.