OrganizationActive
Four Corners Oral and Maxilliofacial Surgery
NPI 1104162452 · Dental Clinic/Center · Durango, CO
Provider details
- NPI number
- 1104162452
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michael Johnson, President(970) 385-5432
- License
- C36335 (CO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
72 Suttle St
S# E
Durango, CO 81303-6829
Phone: (970) 385-5432
Fax: (970) 385-5077
Street-level locationGet directions
Mailing address
72 Suttle St
Durango, CO 81303-6829
Registry dates
- Enumerated
- 2012-12-13
- Last updated
- 2012-12-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.