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

Oral Surgery Specialty

Organization Oral & Maxillofacial Surgery (D.M.D.) · NPI 1790089886

Oral Surgery Specialty is an Oral & Maxillofacial Surgery (D.M.D.) in South Jordan, Utah. Licensed in Utah. Registered with an NPI since 2011.

Licensed in
UT
In the registry since
2011

Practice location Address checks out

3648 W 9800 S
South Jordan, UT 84095-3260
Phone: (801) 397-2727
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 · Licence 135181 (UT)

Record details

NPI number1790089886
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official L. Israelsen — Owner · (801) 397-2727
NPI enumeratedJanuary 4, 2011
Last updated in NPPESNovember 22, 2011
Mailing addressPo Box 367, Draper, UT 84020-0367