# SCOTTSDALE FACIAL & ORAL SURGERY LLC

> 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861032005
- **Authorized official:** MS. KELLI JIMENEZ (FINANCIAL COORDINATOR)
- **Authorized official phone:** (480) 941-5005

## Contact information

- **Practice address:** 3501 N SCOTTSDALE RD STE 226, SCOTTSDALE, AZ 85251-5630
- **Practice address phone:** (480) 941-5005
- **Practice address fax:** (480) 946-0268
- **Mailing address:** 3501 N SCOTTSDALE RD STE 226, SCOTTSDALE, AZ 85251-5630
- **Mailing address phone:** (480) 941-5005
- **Mailing address fax:** (480) 946-0268

## 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:** 01/15/2020
- **Last updated:** 01/15/2020