# OASIS ORAL AND FACIAL SURGERY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023593068
- **Authorized official:** JARED KENNEY DDS (OWNER)
- **Authorized official phone:** (520) 231-6700

## Contact information

- **Practice address:** 21300 N JOHN WAYNE PKWY STE 114, MARICOPA, AZ 85139-8964
- **Practice address phone:** (520) 231-6700
- **Practice address fax:** (520) 208-9066
- **Mailing address:** 21300 N. JOHN WAYNE PKWY STE.\#114, MARICOPA, AZ 85139-7834
- **Mailing address phone:** (520) 231-6700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 09/25/2018
- **Last updated:** 12/28/2024