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

Longmont Oral, Facial & Implant Surgery

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1366975765

Longmont Oral, Facial & Implant Surgery is an Oral and Maxillofacial Surgery (Dentist) in Longmont, Colorado. Licensed in Colorado. Registered with an NPI since 2017.

Licensed in
CO
In the registry since
2017
Specialties on file
2

Practice location Address checks out

1551 Professional Ln Unit 260
Longmont, CO 80501-6903
Phone: (303) 772-8870
Fax: (303) 772-8871
Show map & directions

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

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence DEN.00010071 (CO)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence DEN.00201841 (CO)

Record details

NPI number1366975765
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jamie Leos — Practice Administrator · (303) 772-8870
NPI enumeratedApril 4, 2017
Last updated in NPPESApril 4, 2017
Mailing address1551 Professional Ln Unit 260, Longmont, CO 80501-6903

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