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BOUNTIFUL ORAL SURGERY, P.C.
NPI 1861147100
Dentist - Oral and Maxillofacial Surgery in Bountiful, UT

Active since February 15, 2022
625 E 500 S STE 204, BOUNTIFUL, UT 84010(801) 298-2242(801) 294-9920 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 27, 2025, Feb 15, 2022 (2 updates tracked since 2022).

About Bountiful Oral Surgery, P.c. NPPES

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

BOUNTIFUL ORAL SURGERY, P.C. (NPI 1861147100) is a healthcare organization registered as an oral and maxillofacial surgery in Bountiful, Utah and active in the NPI registry since February 2022. The organization lists Travis Sorensen, Owner, as its authorized official.

NPPES Registry Identity

NPI1861147100
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameBOUNTIFUL ORAL SURGERY, P.C.
Location Address625 E 500 S STE 204Bountiful, UT 84010-3883
Mailing Address625 E 500 S Ste 204Bountiful, UT 84010-3883 · (801) 298-2242
Phone(801) 298-2242
Fax(801) 294-9920
Organization SubpartNo
Authorized OfficialTravis SorensenOwner · (801) 380-5016
Enumeration DateFebruary 15, 2022
Last NPPES UpdateMay 27, 20252 updates tracked since enumeration
NPPES CertifiedMay 27, 2025
✔ NPI 1861147100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
625 E 500 S STE 204, Bountiful, UT 84010
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bountiful Oral Surgery, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bountiful Oral Surgery, P.C., which bills Medicare for the services this clinician delivers.

Clinician (1)

Travis Sorensen, DDS
Oral Surgery
NPI 1679878938
625 E 500 S STE 204
Bountiful, UT 84010
(801) 298-2242
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Bountiful Oral Surgery, P.C.'s NPI number?

The NPI number for Bountiful Oral Surgery, P.C. is 1861147100. It was assigned to this organization in the NPPES registry on February 15, 2022.

Where is Bountiful Oral Surgery, P.C. located?

Bountiful Oral Surgery, P.C. is located at 625 E 500 S Ste 204, Bountiful, UT 84010. The listed phone number is (801) 298-2242.

What is Bountiful Oral Surgery, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Bountiful Oral Surgery, P.C. enrolled in Medicare?

Yes. Bountiful Oral Surgery, P.C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bountiful Oral Surgery, P.C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Oral Surgery) reassigns their Medicare billing to Bountiful Oral Surgery, P.C.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Bountiful Oral Surgery, P.C. accept?

Health plans from UnitedHealthcare list Bountiful Oral Surgery, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bountiful Oral Surgery, P.C. was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.