Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brightside Oral Surgery LLC

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1083569396

Brightside Oral Surgery LLC is an Oral & Maxillofacial Surgery (D.M.D.) in Roy, Utah. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

5682 S 3500 W Unit A
Roy, UT 84067-9108
Phone: (801) 773-9828
Fax: (801) 773-9828
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X

Record details

NPI number1083569396
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ebonie Gonzales — Credentialing Manager · (505) 850-3769
NPI enumeratedMarch 2, 2026
Last updated in NPPESMarch 2, 2026
Certification dateMarch 2, 2026
Mailing address5682 S 3500 W Unit A, Roy, UT 84067-9108