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

Phoenix Oral Surgery Associates PLLC

Organization Clinic/Center · NPI 1619693793

Phoenix Oral Surgery Associates PLLC is a Clinic/Center in Phoenix, Arizona. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

20950 N Tatum Blvd Ste 200
Phoenix, AZ 85050-4269
Phone: (480) 284-8087
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1619693793
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vishtasb Broumand — Owner · (480) 284-8087
Other names Desert Ridge Oral Surgery Institute
NPI enumeratedOctober 19, 2022
Last updated in NPPESOctober 19, 2022
Certification dateOctober 19, 2022
Mailing address20950 N Tatum Blvd Ste 200, Phoenix, AZ 85050-4269

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