THE CENTER FOR ORAL, FACIAL, AND IMPLANT SURGERY PA


Address: 2310 Highway 157 N, Suite 103, Mansfield, TX 76063-8844
Phone: 8174770922

THE CENTER FOR ORAL, FACIAL, AND IMPLANT SURGERY PA (NPI# 1467694208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467694208
Entity Type Organization
Organization Name THE CENTER FOR ORAL, FACIAL, AND IMPLANT SURGERY PA
Practice Address 2310 Highway 157 N
Suite 103
Mansfield
TX 76063-8844
Practice Telephone 8174770922
Practice Fax Number 8174770910
Mailing Telephone 8174770922
Mailing Fax Number 8174770910
Enumeration Date 2009-03-25
Last Update Date 2009-03-25
Authorized Official Name MICHAEL DERAE SHEPPARD (PRESIDENT)
Authorized Official Telephone 8174770922
Authorized Official Credential OMS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
21182 TX Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX MEDICARE ID 8F2168 01

Office Location

Street Address 2310 HIGHWAY 157 N
SUITE 103
City MANSFIELD
State TX
Zip Code 76063-8844

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992814776 Yetunde Abayomi Dentist 2310 Highway 157 N, Suite 102, Mansfield, TX 76063-8844 2006-08-29
1770765679 Forever Smiles, P.a. Dentist 2310 Highway 157 N, Suite # 102, Mansfield, TX 76063-8844 2007-12-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1316558349 Lindsey Vandyke, D.o. Pllc Internal Medicine 3150 E Broad Street, Ste 100, Mansfield, TX 76063 2020-08-13
1942819867 Jennifer Que Chau Nguyen Pharmacist 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 2020-07-27
1194346890 Ana Maria Gonzalez Dentist 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 2020-05-04
1245869080 Stateserv Medical of Texas, LLC Durable Medical Equipment & Medical Supplies 7941 Rodeo Trail, Mansfield, TX 76063 2020-04-03
1649802232 Mary Puanani Kamai Nurse Practitioner 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 2020-02-11
1770123028 Gladys Vera Nfodzo Nurse Practitioner 901 W. Broad St, Mansfield, TX 76063 2020-01-14
1669011300 Alexa Smith Nurse Practitioner 2800 E Broad St #304, Mansfield, TX 76063 2019-12-28
1477190437 Mel Rockwall LLC Optometrist 1701 East Broad Street, Ste 109, Mansfield, TX 76063 2019-12-09
1376185512 Daniel Max & Marcandrea LLC Optometrist 1701 East Broad St., Ste 109, Mansfield, TX 76063 2019-10-09
1861046385 Lacey Eaton Counselor 805 Killian Dr, Mansfield, TX 76063 2019-08-01
Find all providers in zip 76063

Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes 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.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1972771053 Mansfield Oral and Facial Surgery Dentist 1705 Fountainview Dr #103, Mansfield, TX 76063 2008-02-12
1083793210 Marie Christine Boucher Dentist 10 Higgins Highway, Mansfield, CT 06250 2006-11-06
1871547893 Michael Derae Sheppard Dentist 2310 Fm 157 North, Suite 103, Mansfield, TX 76063 2006-05-22
1780632307 Douglas Philip Sinn Dentist 1752 Broad Park Cir N, #100, Mansfield, TX 76063-7821 2006-05-05
1790752350 Kenneth J. Molnar Dentist 2191 Park Ave W, Mansfield, OH 44906-1226 2006-03-02
1760003891 Dynamic Dental Specialists, LLC Dentist 630 Lexington Ave, Mansfield, OH 44907-1500 2020-04-29
1306340567 Oakwood Oral and Maxillofacial Surgery, Christopher N. Beale, Dds, LLC Dentist 630 Lexington Ave, Mansfield, OH 44907-1500 2018-03-22
1306077656 Timothy Scott Bartholomew Dentist 630 Lexington Ave, Mansfield, OH 44907-1500 2009-08-05
1518125749 Dr Jon D Turesky Dmd Dentist 100 Copeland Drive, Mansfield, MA 02048 2008-05-23
1437357894 Douglas P. Sinn, Dds, Pa Dentist 1752 Broad Park Cir N, #100, Mansfield, TX 76063-7821 2007-07-06
Find all providers in MANSFIELD

Competitor

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City MANSFIELD
Zip Code 76063

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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