Brownwood Smilecrafters, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12014 Issued in TX

Legal business name

BROWNWOOD SMILECRAFTERS, PLLC

Practice address

3709 Austin Ave
Brownwood, TX 76801-6626

Phone

(325) 646-0516

NPI assigned

May 30, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeanne Hansen Bayless, DDS

Title

President

Phone

(325) 673-8164

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338336000000",
    "number": "1013278779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 AUSTIN AVE",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768016626",
            "telephone_number": "325-646-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 AUSTIN AVE",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768016626",
            "telephone_number": "325-646-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWNWOOD SMILECRAFTERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-05-30",
        "status": "A",
        "authorized_official_last_name": "BAYLESS",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "HANSEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "325-673-8164",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "12014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208670402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Brownwood, TX
• Providers in Brownwood, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.