Amarillo Oral Surgery, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

23648 Issued in TX

Legal business name

AMARILLO ORAL SURGERY, LLC

Doing business as

Amarillo Oral & Maxillofacial Surgery, LLC

Practice address

3501 S Soncy Rd
Suite 126
Amarillo, TX 79119-6407

Phone

(806) 353-1055

NPI assigned

Apr 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. William Edward Graves, DMD

Title

Owner/Doctor

Phone

(806) 353-1055

Specialties & licenses 1

Addresses

Other names 1

• Amarillo Oral & Maxillofacial Surgery, LLC Doing business as

Locations

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1053584425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5051 S. SONCY RD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79119",
            "telephone_number": "806-353-1055",
            "fax_number": "806-353-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S SONCY RD",
            "address_2": "SUITE 126",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791196407",
            "telephone_number": "806-353-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARILLO ORAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "806-353-1055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amarillo Oral & Maxillofacial Surgery, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Amarillo, TX
• Providers in Amarillo, 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 Mar 3, 2016; 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.