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Contact Information

ORAL SURGERY SPECIALTY
3648 W 9800 S
SOUTH JORDAN, UT84095-3260
 Phone: 801-397-2727
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for ORAL SURGERY SPECIALTY

NPI Number 1790089886
LBN Legal business name ORAL SURGERY SPECIALTY
Authorized official L. ISRAELSEN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/04/2011
Last updated 11/22/2011 - About 15 years ago
Identifiers
UT License # 135181
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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