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General NPI Number Information
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NPI Number | 1740066349
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Entity Type | Organization
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Legal Business Name | SCOTTSDALE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES PLLC
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 08/07/2026
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Provider Practice Location Address
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Address Line | 6945 E SAHUARO DR STE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-6722
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Country | US
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Telephone | 503-412-8579
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Fax |
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Provider Business Mailing Address
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Address Line | 11029 N 128TH PL
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-4467
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Country | US
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Telephone | 503-412-8579
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAYSON KIRCHHOFER
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Credential | DMD, MD
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Telephone | 503-412-8579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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