ROSWELL ORAL & FACIAL SURGERY, LLC (NPI# 1518351790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518351790 |
| Entity Type | Organization |
| Organization Name | ROSWELL ORAL & FACIAL SURGERY, LLC |
| Practice Address |
207 N Union Ave Ste E Roswell NM 88201-3068 |
| Mailing Address |
2103 Telshor Ct Las Cruces NM 88011-8245 |
| Practice Telephone | 5756235711 |
| Practice Fax Number | 5756228922 |
| Mailing Telephone | 5755228800 |
| Mailing Fax Number | 5755214448 |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2015-03-25 |
| Authorized Official Name | DR. BRYCE HEINER (OWNER/SURGEON) |
| Authorized Official Telephone | 5755228800 |
| Authorized Official Credential | DMD, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DD3068 | NM | Dental Providers |
| Street Address |
207 N UNION AVE STE E |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201-3068 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598752370 | Crossroads Counseling, Inc. | Social Worker | 207 N Union Ave, Suite G, Roswell, NM 88201-3068 | 2005-10-05 |
| 1881845170 | John C. Henry, M.d., P.a. | Dermatology | 207 N Union Ave, Suite C, Roswell, NM 88201-3068 | 2008-10-05 |
| 1144408493 | Gordon Moore | Dentist | 207 N Union Ave, Suite A, Roswell, NM 88201-3068 | 2008-02-07 |
| 1154459006 | Pro-optical Express Ltd. | Technician/Technologist | 207 N Union Ave, Roswell, NM 88201-3068 | 2007-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
| Find all providers in zip 88201 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053629089 | Oms of Se Nm, LLC | Dentist | 207 N. Union Ste. E, Oms of Se Nm, LLC, Roswell, NM 88201-3068 | 2010-09-24 |
| 1962526707 | Mollie Ann Winston | Dentist | 10930 Crabapple Rd Ste 160, Roswell, GA 30075-7631 | 2007-03-19 |
| 1982624375 | Robert James Kakos | Dentist | 1150 Grimes Bridge Rd, Suite 200, Roswell, GA 30075-3988 | 2006-07-20 |
| 1750607024 | Robert Safwat Attia | Dentist | 1150 Grimes Bridge Rd, Suite 200, Roswell, GA 30075-3988 | 2010-04-12 |
| 1093866642 | Thomas David Boc | Dentist | 2500 Hospital Blvd, Ste 370, Roswell, GA 30076-4907 | 2007-01-12 |
| 1295849792 | Ben M Smith Dmd PC | Dentist | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629460951 | Mark Conover | Dentist | 7050 Barstow St Ne, Albuquerque, NM 87111-1056 | 2015-02-24 |
| 1578969754 | Simply Dental & Oral Surgery PC | Dentist | 4760 N Butler Ave Ste B1, Farmington, NM 87401-0816 | 2014-11-14 |
| 1508287541 | Santa Fe Oral Surgery, LLC | Dentist | 2100 Calle Dela Vueila Ste B103, B103, Santa Fe, NM 87505-4749 | 2013-12-17 |
| 1780930545 | Drew Steel | Dentist | 915 Mesa Roja Trl Ne, Rio Rancho, NM 87124-6388 | 2012-07-31 |
| 1265671770 | Sandia Oral Surgery and Dental Implant Center | Dentist | 7009 Montgomery Blvd. Ne, Albuquerque, NM 87109 | 2009-02-08 |
| 1598929242 | West Mesa Oral and Maxillofacial Surgery PC | Dentist | 4801 Mcmahon Blvd Nw Ste 230, Albuquerque, NM 87114-5478 | 2008-07-11 |
| 1013179530 | Joyce Ann Jeffries | Dentist | 9674 Eagle Ranch Rd Nw, Suite 1, Albuquerque, NM 87114-1580 | 2008-06-26 |
| 1134396567 | John J Mcneill | Dentist | 2401 E 30th St Bldg 2, Farmington, NM 87401-8986 | 2008-05-14 |
| 1457527368 | Southwest Oral & Maxillofacial Surgery | Dentist | 5900 Cubero Dr Ne Ste A, Albuquerque, NM 87109-3879 | 2008-05-01 |
| 1942352208 | Edward Joseph Urig Jr. | Dentist | 1700 Hospital Dr, Santa Fe, NM 87505 | 2007-01-17 |
| Find all providers with the same taxonomy | ||||
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| 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.