SUMMIT ORAL & MAXILLOFACIAL SURGERY (NPI# 1679955017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679955017 |
| Entity Type | Organization |
| Organization Name | SUMMIT ORAL & MAXILLOFACIAL SURGERY |
| Practice Address |
1250 E 3900 S Ste 210 Salt Lake City UT 84124-1348 |
| Mailing Address |
1250 E 3900 S Ste 210 Salt Lake City UT 84124-1367 |
| Practice Telephone | 8012651500 |
| Practice Fax Number | 8012659963 |
| Mailing Telephone | 8012651500 |
| Mailing Fax Number | 8012659963 |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2015-06-23 |
| Authorized Official Name | BARBARA J DURANT (COLLECTION MANAGER) |
| Authorized Official Telephone | 8012651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
7835316 | UT | Dental Providers |
| Street Address |
1250 E 3900 S STE 210 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124-1348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275530305 | Camille Collett | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2005-07-05 |
| 1548795792 | Cammey Young | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2017-04-25 |
| 1285167015 | Danielle Williamson Lin | Student in an Organized Health Care Education/Training Program | 1250 E 3900 S, 260, Salt Lake City, UT 84124-1348 | 2017-04-08 |
| 1609308717 | Brian Christopher Johnson | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2017-03-29 |
| 1144776089 | Rosemarie Linsler | Nurse Practitioner | 1250 E 3900 S, #260, Salt Lake City, UT 84124-1348 | 2016-08-31 |
| 1104289487 | Alec Kitch | Family Medicine | 1250 E 3900 S, Suite #260 Br, Salt Lake City, UT 84124-1348 | 2016-04-03 |
| 1538522461 | Ian Michael Mcdaniels | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2016-03-29 |
| 1891151668 | Abby N Crume Do PC | Colon & Rectal Surgery | 1250 E 3900 S, Ste 320, Salt Lake City, UT 84124-1348 | 2016-01-11 |
| 1447667217 | Granger Medical Clinic, Inc. | Clinic/Center | 1250 E 3900 S, Suite 250, Salt Lake City, UT 84124-1348 | 2014-07-14 |
| 1609280486 | Alyse Williams | Family Medicine | 1250 E 3900 S, Suite 260, Salt Lake City, UT 84124-1348 | 2014-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| 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 |
|---|---|---|---|---|
| 1265690028 | Dustin J Hopkin | Dentist | 2180 E 4500 S Ste 285, Salt Lake City, UT 84117-4028 | 2008-05-29 |
| 1013040237 | Oscar Daniel Bluth | Dentist | 515 S 1000 E, Suite L-2 West, Salt Lake City, UT 84102-3003 | 2007-03-14 |
| 1295811800 | Andrew Ronald Rahn | Dentist | 50 N Medical Dr # 7, Salt Lake City, UT 84132-0001 | 2006-10-27 |
| 1669554119 | Kenneth J. Baldwin | Dentist | 4046 Highland Dr, Suite #112, Salt Lake City, UT 84124-1673 | 2006-10-20 |
| 1508874090 | David Joseph Smoot | Dentist | 6095 So 300 E, #120, Salt Lake City, UT 84107 | 2006-08-03 |
| 1508872045 | Ralph W. Ryser | Dentist | 6287 S Redwood Rd Ste 103, Salt Lake City, UT 84123-6653 | 2006-08-01 |
| 1679089239 | Blaine D. Austin Dds Inc. | Dentist | 1250 East 3900 South, Suite 210, Salt Lake City, UT 84124 | 2017-12-19 |
| 1548792468 | Aspire Surgical | Dentist | 6268 S 900 E, Suite 100, Salt Lake City, UT 84121-2497 | 2017-03-30 |
| 1497124259 | Flint & Steel Surgical | Dentist | 4970 S 900 E, Suite C, Salt Lake City, UT 84117-5776 | 2015-09-22 |
| 1063880896 | Utah & Oral & Facial Surgeons | Dentist | 6268 S 900 E, 100, Salt Lake City, UT 84121-2497 | 2015-09-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
Please comment or provide details below to improve the information on SUMMIT ORAL & MAXILLOFACIAL SURGERY.
| 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.