STONE ORAL FACIAL SURGERY GROUP PLLC (NPI# 1912258740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912258740 |
Entity Type | Organization |
Organization Name | STONE ORAL FACIAL SURGERY GROUP PLLC |
Other Organization Name | SOUTHERN SURGICAL ARTS |
Practice Address |
2550 Elkton Trl Tyler TX 75703-0594 |
Practice Telephone | 9035341414 |
Practice Fax Number | 9035341415 |
Mailing Telephone | 9035341414 |
Mailing Fax Number | 9035341415 |
Enumeration Date | 2012-09-19 |
Last Update Date | 2013-12-26 |
Authorized Official Name | DR. CHARLES G STONE JR. (OWNER/OFFICER) |
Authorized Official Telephone | 9035341414 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 1206989-09 | 05 | |
TX | 1206989-08 | 05 | |
TX | 2032740-06 | 05 | |
TX | 1896953-05 | 05 | |
TX | 1896953-06 | 05 | |
TX | 1305898-08 | 05 | |
TX | 3099020-01 | 05 | |
TX | 3126690-03 | 05 | |
TX | 1305898-09 | 05 | |
TX | 2032740-07 | 05 |
Other Name | Type Code |
---|---|
Southern Surgical Arts | Doing Business As Name - Organization |
Street Address |
2550 ELKTON TRL |
City | TYLER |
State | TX |
Zip Code | 75703-0594 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447886619 | East Texas Omfs Trauma Consultants, Pllc | Dentist | 2550 Elkton Trl, Tyler, TX 75703-0594 | 2020-03-19 |
1740612084 | Wade Ryan Barker | Dentist | 2550 Elkton Trl, Tyler, TX 75703 | 2013-08-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
Find all providers in zip 75703 |
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 |
---|---|---|---|---|
1386874063 | Charles G. Stone, Jr. Dds PC | Dentist | 3100 New Copeland Rd., Tyler, TX 75701 | 2009-07-16 |
1851466064 | Stephen James Cosentino | Dentist | 1215 Doctors Drive, Tyler, TX 75701 | 2006-11-22 |
1306918172 | Willie Joe Parks Jr. | Dentist | 815 S Fleishel Ave, Tyler, TX 75701-2017 | 2006-11-15 |
1639241599 | Dennis Ross Spence | Dentist | 700 Olympic Plaza Cir Ste 412, Tyler, TX 75701-1952 | 2006-11-15 |
1417067497 | Makoto Saigusa | Dentist | 805 Turtle Creek Dr, Tyler, TX 75701-1937 | 2006-08-30 |
1841219342 | Charles Glenn Stone Jr. | Dentist | 3100 New Copeland Rd, Tyler, TX 75701-7940 | 2006-07-18 |
1447886619 | East Texas Omfs Trauma Consultants, Pllc | Dentist | 2550 Elkton Trl, Tyler, TX 75703-0594 | 2020-03-19 |
1740612084 | Wade Ryan Barker | Dentist | 2550 Elkton Trl, Tyler, TX 75703 | 2013-08-08 |
1124393434 | Barry G Acker Dds Pa | Dentist | 3100 New Copeland Rd, Tyler, TX 75701-7940 | 2012-03-20 |
1497054712 | Will J Parks Dds Md Pa | Dentist | 815 S Fleishel Ave, Tyler, TX 75701-2017 | 2011-03-25 |
Find all providers in TYLER |
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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.