Cleburne Oral Surgery PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CLEBURNE ORAL SURGERY PA

Practice address

2010 W Katherine P Raines Rd Ste 700
Cleburne, TX 76033-7462

Phone

(817) 357-8999

Fax

(817) 357-8998

NPI assigned

Jan 31, 2025

Last updated

Jan 31, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Wayne Kostohryz Jr., DDS, MD

Title

Owner

Phone

(817) 357-8999

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1043023088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD STE 700",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337462",
            "telephone_number": "817-357-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD STE 700",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337462",
            "telephone_number": "817-357-8999",
            "fax_number": "817-357-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEBURNE ORAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A",
        "authorized_official_last_name": "KOSTOHRYZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-357-8999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cleburne Internal Medicine Associates, PA
• Cleburne Interventional Pain & Surgery, LLC
• Cleburne Interventional Pain Procedure Center LLC
• Cleburne Isd
• Cleburne OB & GYN Associates
• Cleburne Pathology, PA
• Cleburne Pediatrics P.a.
• Cleburne Physical Therapy & Sports Rehabilitation, Inc. (Cleburne Physical Therapy)
• Cleburne Surgical Center, LLC
• Elliott Lee Cohen, MD

• Oral and Maxillofacial Surgery (Dentist) in Cleburne, TX
• Providers in Cleburne, 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 Jan 31, 2025; 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.