Richardson Oral Surgery and Implant Center PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22690 Issued in TX

Legal business name

RICHARDSON ORAL SURGERY AND IMPLANT CENTER PLLC

Practice address

1070 W Campbell Rd
Suite 200
Richardson, TX 75080-2941

Phone

(972) 231-6661

Fax

(972) 231-3161

NPI assigned

Jul 28, 2015

Organization subpart

No

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

Authorized official

Name

Campbell Bourland, DDS, MS

Title

Doctor/Owner

Phone

(972) 231-6661

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1013392463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 W CAMPBELL RD",
            "address_2": "SUITE 200",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802941",
            "telephone_number": "972-231-6661",
            "fax_number": "972-231-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 W CAMPBELL RD",
            "address_2": "SUITE 200",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802941",
            "telephone_number": "972-231-6661",
            "fax_number": "972-231-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARDSON ORAL SURGERY AND IMPLANT CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "BOURLAND",
        "authorized_official_first_name": "CAMPBELL",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "972-231-6661",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "22690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richardson Integrated Health
• Richardson Interventional Pain Procedure Center, LLC
• Richardson Mimosa Medical Center
• Richardson Nursing and Rehab Center, LLC
• Richardson Oral & Maxillofacial Surgery Associates, Inc.
• Richardson Pediatric Associates
• Richardson Physical Therapy Clinic
• Richardson Physician Alliance
• Richardson Primarycare Clinic LLC
• Richardson Smiles PLLC

• Oral and Maxillofacial Surgery (Dentist) in Richardson, TX
• Providers in Richardson, 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 Jul 28, 2015; 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.