SOUTHERN UTAH SURGICAL ARTS (NPI# 1962918094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962918094 |
| Entity Type | Organization |
| Organization Name | SOUTHERN UTAH SURGICAL ARTS |
| Other Organization Name | ORAL & FACIAL SURGERY INSTITUTE |
| Practice Address |
393 E Riverside Dr, Ste 2b St. George UT 84790 |
| Mailing Address |
393 E Riverside Dr, Ste 2b St George UT 84790 |
| Practice Telephone | 4356281100 |
| Practice Fax Number | 4356730330 |
| Mailing Telephone | 4356281100 |
| Mailing Fax Number | 4356730330 |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |
| Authorized Official Name | DR. SHAWN B DAVIS (OWNER) |
| Authorized Official Telephone | 4356281100 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204E00000X | Oral & Maxillofacial Surgery | D07932 | AZ | Allopathic & Osteopathic Physicians |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 6524667 | UT | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Oral & Facial Surgery Institute | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790012243 | Southern Utah Surgical Arts | Dentist | 393 E Riverside Dr Bldg 2, Suite 2b, St George, UT 84790-7065 | 2009-11-04 |
| Street Address |
393 E RIVERSIDE DR, STE 2B |
| City | ST. GEORGE |
| State | UT |
| Zip Code | 84790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1790089886 | Oral Surgery Specialty | Oral & Maxillofacial Surgery | 3648 W 9800 S, South Jordan, UT 84095-3260 | 2011-01-04 |
| 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 | ST. GEORGE |
| Zip Code | 84790 |
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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.