| Face And Jaw Surgeons Pc | |
|
1140 W Capitol Ave Bismarck ND 58501-9956 | |
| (701) 258-7220 | |
| (701) 222-2329 |
| Full Name | Face And Jaw Surgeons Pc |
|---|---|
| Speciality | Dentist |
| Location | 1140 W Capitol Ave, Bismarck, North Dakota |
| Authorized Official Name and Position | Joseph R Deatherage (DMD MD) |
| Authorized Official Contact | 7012587220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Face And Jaw Surgeons Pc 1730 Burnt Boat Dr Ste 300 Bismarck ND 58503-0886 Ph: (701) 258-7220 | Face And Jaw Surgeons Pc 1140 W Capitol Ave Bismarck ND 58501-9956 Ph: (701) 258-7220 |
| NPI Number | 1184667305 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 04/25/2019 |
| Medicare PECOS PAC ID | 1153311881 |
|---|---|
| Medicare Enrollment ID | O20040514000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184667305 | NPI | - | NPPES |
| 41124 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Brian E Schwindt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841389095 PECOS PAC ID: 3870490469 Enrollment ID: I20031212000525 |
| Provider Name | Charles A Crago |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1629147723 PECOS PAC ID: 2466516182 Enrollment ID: I20090126000082 |
| Provider Name | Omar C Chahal |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1639248719 PECOS PAC ID: 3779624184 Enrollment ID: I20100107000437 |
| Provider Name | Lura J Spears |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619208675 PECOS PAC ID: 6507991858 Enrollment ID: I20100312000083 |
| Provider Name | Joseph R Deatherage |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1003859117 PECOS PAC ID: 5395764278 Enrollment ID: I20100511001065 |
| Provider Name | Kelli J Gabel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205133873 PECOS PAC ID: 7810179835 Enrollment ID: I20110314000172 |
| Provider Name | Jonathan R Gray |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1508048521 PECOS PAC ID: 5597933358 Enrollment ID: I20110721000417 |
| Provider Name | Lenae R Frolek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134393135 PECOS PAC ID: 6507945953 Enrollment ID: I20140228001319 |
| Provider Name | Preston A Gomez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1144541533 PECOS PAC ID: 1557589926 Enrollment ID: I20140826002276 |
| Provider Name | Tuan G Bui |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1548385065 PECOS PAC ID: 5092989301 Enrollment ID: I20160314001750 |
| Provider Name | Michael R Knoll |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1669691200 PECOS PAC ID: 0042341851 Enrollment ID: I20190215002112 |
| Provider Name | Kimberly A Moon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083172969 PECOS PAC ID: 5799026530 Enrollment ID: I20190404002225 |
| Provider Name | Derek M Miller |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1205366002 PECOS PAC ID: 2365842457 Enrollment ID: I20210610002518 |
Rmhc School Based Sealant Program Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 609 N 7th St, Bismarck, ND 58501 Phone: 701-258-8551 | |
Pinehurst Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 W Interstate Ave, Ste 132, Bismarck, ND 58503 Phone: 701-223-1476 Fax: 701-223-4503 | |
Bismarck Advanced Dental And Implants Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1004 S. 7th Street, Bismarck, ND 58504 Phone: 701-390-1920 Fax: 701-255-4055 | |
Mjw Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 531 S 7th St, Bismarck, ND 58504 Phone: 701-224-1558 | |
A To Z Pediatric Dentistry, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1929 N Washington St Ste Op, Bismarck, ND 58501 Phone: 701-751-7555 Fax: 701-751-6444 | |
Valerie Anne Drake Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 726 S 2nd St, Bismarck, ND 58504 Phone: 701-258-1321 | |
Custom Endodontics, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 521 E Main Ave, Suite 100, Bismarck, ND 58501 Phone: 701-255-2523 Fax: 701-525-5765 |