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CANYON COUNTY ORAL MAXILLOFACIAL SURGERY
NPI 1710184783
Dentist - Oral and Maxillofacial Pathology in Caldwell, ID

Active since July 02, 2007
4121 CLOCK TOWER AVE, CALDWELL, ID 83607(208) 459-7800 Get Directions Write a Review

NPPES record last updated: July 10, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Canyon County Oral Maxillofacial Surgery NPPES

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

CANYON COUNTY ORAL MAXILLOFACIAL SURGERY (NPI 1710184783) is a healthcare organization registered as an oral and maxillofacial pathology in Caldwell, Idaho and active in the NPI registry since July 2007. The organization lists Nicholas A Massoth, Oral Surgeon, as its authorized official.

NPPES Registry Identity

NPI1710184783
Entity TypeOrganization
Primary Taxonomy1223P0106X
Legal Business NameCANYON COUNTY ORAL MAXILLOFACIAL SURGERY, INC
Location Address4121 CLOCK TOWER AVECaldwell, ID 83607-5006
Mailing Address4121 Clock Tower AveCaldwell, ID 83607-5006 · (208) 459-7800
Phone(208) 459-7800
Organization SubpartNo
Authorized OfficialNicholas A MassothOral Surgeon · (208) 459-7800
Enumeration DateJuly 2, 2007
Last NPPES UpdateJuly 10, 2007
✔ NPI 1710184783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial PathologyDental Providers
Taxonomy Code1223P0106X
License✔ Licensed in ID · D3848OS
Definition
The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations.
4121 CLOCK TOWER AVE, Caldwell, ID 83607
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Other Names 1

Doing Business AsCanyon County Oral Maxillofacial Surgery

Other Identifiers 3

Other10149985ID · Regence Blue Shield
Other6L859ID · Blue Cross Of Id
Other1783151ID · United Concordia

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

NICHOLAS A MASSOTH D.M.D.
Dentist (Oral and Maxillofacial Pathology)
4121 CLOCK TOWER AVE
CALDWELL, ID 83607
Canyon County (208) 459-7800

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 Canyon County Oral Maxillofacial Surgery, Inc's NPI number?

The NPI number for Canyon County Oral Maxillofacial Surgery, Inc is 1710184783. It was assigned to this organization in the NPPES registry on July 2, 2007. The provider is doing business as Canyon County Oral Maxillofacial Surgery.

Where is Canyon County Oral Maxillofacial Surgery, Inc located?

Canyon County Oral Maxillofacial Surgery, Inc is located at 4121 Clock Tower Ave, Caldwell, ID 83607. The listed phone number is (208) 459-7800.

What is Canyon County Oral Maxillofacial Surgery, Inc's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Pathology, with taxonomy code 1223P0106X.

When was this NPI record last updated?

The NPPES record for Canyon County Oral Maxillofacial Surgery, Inc was last updated on July 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.