# AZ MAX SURGEONS PLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Arizona Maxillofacial Surgeons PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528530284
- **Authorized official:** JILIAN PORTER (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (480) 830-5866

## Contact information

- **Practice address:** 6755 E SUPERSTITION SPRINGS BLVD STE 103, MESA, AZ 85206-4375
- **Practice address phone:** (480) 830-5866
- **Practice address fax:** (480) 807-0606
- **Mailing address:** 6755 E SUPERSTITION SPRINGS BLVD STE 103, MESA, AZ 85206-4375
- **Mailing address phone:** (480) 830-5866
- **Mailing address fax:** (480) 807-0606

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 12/19/2018
- **Last updated:** 07/30/2021