OrganizationActive
Brightside Oral Surgery LLC
NPI 1144163833 · Oral & Maxillofacial Surgery (D.M.D.) · Syracuse, UT
Provider details
- NPI number
- 1144163833
- Entity type
- Organization
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ebonie Gonzales, Credentialing Manager(505) 850-3769
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
1562 S 3000 W Ste 100
Syracuse, UT 84075-2003
Phone: (801) 773-8644
Fax: (801) 773-9828
Street-level locationGet directions
Mailing address
1562 S 3000 W Ste 100
Syracuse, UT 84075-2003
Registry dates
- Enumerated
- 2026-04-09
- Last updated
- 2026-04-09
- Certified
- 2026-04-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.