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FOUR CORNERS ORAL AND MAXILLIOFACIAL SURGERY
NPI 1104162452
Clinic/Center - Dental in Durango, CO

Active since December 13, 2012
72 SUTTLE ST, S# E, DURANGO, CO 81303(970) 385-5432(970) 385-5077 Get Directions Write a Review

NPPES record last updated: December 13, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Four Corners Oral And Maxilliofacial Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOUR CORNERS ORAL AND MAXILLIOFACIAL SURGERY (NPI 1104162452) is a healthcare organization registered as a dental in Durango, Colorado and active in the NPI registry since December 2012. The organization lists Michael Walter Johnson, President, as its authorized official.

NPPES Registry Identity

NPI1104162452
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameFOUR CORNERS ORAL AND MAXILLIOFACIAL SURGERY
Location Address72 SUTTLE ST, S# EDurango, CO 81303-6829
Mailing Address72 Suttle St, S# EDurango, CO 81303-6829 · (970) 385-5432 · Fax (970) 385-5077
Phone(970) 385-5432
Fax(970) 385-5077
Organization SubpartNo
Authorized OfficialMichael Walter JohnsonPresident · (970) 385-5432
Enumeration DateDecember 13, 2012
✔ NPI 1104162452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in CO · C36335
72 SUTTLE ST, Durango, CO 81303
Open in Google Maps ↗

Other Identifiers 2

Medicare PINC46741CO
Medicare UPING87185CO

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SCOTT MICHAEL JAPHET
Massage Therapist
72 SUTTLE ST, STE B
DURANGO, CO 81303
La Plata County (970) 946-0292
JOANNA BETH DOMINICK DNP, PMHNP-BC, FNP-C
Nurse Practitioner (Psychiatric/Mental Health)
72 SUTTLE ST, SUITE B
DURANGO, CO 81303
La Plata County (970) 444-2429
DURANGO DIALYSIS CENTER LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
72 SUTTLE ST, STE D
DURANGO, CO 81303
La Plata County (970) 385-8608
MASON O MINER DDS LLC
Durable Medical Equipment & Medical Supplies
72 SUTTLE ST, STE H
DURANGO, CO 81303
La Plata County (970) 247-2677
MRS. DEBORAH BRILL MEYERS MS NP
Nurse Practitioner (Adult Health)
72 SUTTLE ST, SUITE C
DURANGO, CO 81303
La Plata County (970) 403-8812
DR. MICHAEL WALTER JOHNSON M.D. & DDS
Dentist (Oral and Maxillofacial Surgery)
72 SUTTLE ST, S# E
DURANGO, CO 81303
La Plata County (970) 385-5432

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Four Corners Oral And Maxilliofacial Surgery's NPI number?

The NPI number for Four Corners Oral And Maxilliofacial Surgery is 1104162452. It was assigned to this organization in the NPPES registry on December 13, 2012.

Where is Four Corners Oral And Maxilliofacial Surgery located?

Four Corners Oral And Maxilliofacial Surgery is located at 72 Suttle St S# E, Durango, CO 81303. The listed phone number is (970) 385-5432.

What is Four Corners Oral And Maxilliofacial Surgery's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Four Corners Oral And Maxilliofacial Surgery was last updated on December 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.