LAKESIDE ORAL & MAXILLOFACIAL SURGERY; NPI #1417898560

Contact Information

LAKESIDE ORAL & MAXILLOFACIAL SURGERY

1528 N COMMERCE DR STE 203
SARATOGA SPRINGS, UT 84045-4031

Phone: 801-224-1200
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for LAKESIDE ORAL & MAXILLOFACIAL SURGERY

NPI Number	`1417898560`
LBN Legal business name	LAKESIDE ORAL & MAXILLOFACIAL SURGERY
Authorized official	JARED RASMUSSEN - (OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	04/02/2026
Last updated	04/02/2026 - About 2 months ago
Identifiers	n/a

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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LAKESIDE ORAL & MAXILLOFACIAL SURGERY

Contact Information

Specialty

Oral and Maxillofacial Surgery

NPI Profile & details for LAKESIDE ORAL & MAXILLOFACIAL SURGERY

Reviews for LAKESIDE ORAL & MAXILLOFACIAL SURGERY