SOUTHWEST ORAL AND FACIAL SURGERY INC (NPI# 1821400532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821400532 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST ORAL AND FACIAL SURGERY INC |
| Practice Address |
11748 S 3600 W Suite 1 South Jordan UT 84095-5922 |
| Practice Telephone | 8019383412 |
| Practice Fax Number | 8019383413 |
| Mailing Telephone | 8019383412 |
| Mailing Fax Number | 8019383413 |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |
| Authorized Official Name | MR. JARED MATHEW BROWN (OWNER/SURGEON) |
| Authorized Official Telephone | 8019383412 |
| Authorized Official Credential | D.D.S, M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
355097-9924 | UT | Ambulatory Health Care Facilities |
| Street Address |
11748 S 3600 W SUITE 1 |
| City | SOUTH JORDAN |
| State | UT |
| Zip Code | 84095-5922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326167354 | Jared M Brown | Dentist | 11748 S 3600 W, South Jordan, UT 84095-5922 | 2007-03-29 |
| 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 | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| 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 |
|---|---|---|---|---|
| 1962038711 | Stanley Oral & Facial Surgery Pllc | Clinic/Center | 3632 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7163 | 2020-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912507153 | Legacy Heights Oral & Facial Surgery Pllc | Clinic/Center | 193 S 200 W Ste B, Farmington, UT 84025-2406 | 2020-10-27 |
| 1598024341 | Logan Oral Surgery | Clinic/Center | 3125 N. Main Street, Ste #103, North Logan, UT 84341-1550 | 2012-05-15 |
| 1851937270 | Randy Sean Barnhisel Dds, Pllc | Clinic/Center | 4970 S 900 E Ste G, Salt Lake City, UT 84117-3930 | 2019-11-20 |
| 1558744748 | Ryan K Austin, Dds PC | Clinic/Center | 5742 S 1475 E Ste 100, South Ogden, UT 84403-4857 | 2015-07-07 |
| 1376827832 | Dustin J Hopkin Dds, Oral and Maxillofacial Surgery P.C. | Clinic/Center | 2180 E 4500 S Ste 285, Salt Lake City, UT 84117-4028 | 2011-10-03 |
| 1275722357 | Utah Surgical Arts | Clinic/Center | 3610 N University Ave, Suite 150, Provo, UT 84604-4437 | 2007-10-15 |
| City | SOUTH JORDAN |
| Zip Code | 84095 |
Please comment or provide details below to improve the information on SOUTHWEST ORAL AND FACIAL SURGERY INC.
| 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.