Axpm Oral Surgery PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

AXPM ORAL SURGERY PLLC

Doing business as

Impact Oral Surgery

Practice address

2305 Springhill Rd
Suite 1
Bryant, AR 72019-7552

Phone

(501) 408-4774

NPI assigned

Feb 24, 2015

Last updated

Feb 24, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

MARK L. DAKE, DDS, MSD AND BRYAN C. HILLER, DMD, MS ORTHODONTIC ASSOCIAs reported in NPPES

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

Authorized official

Name

Dr. Bryan Hiller, DDS, MS

Title

Manager

Phone

(501) 781-2777

Specialties & licenses 1

Addresses

Other names 1

• Impact Oral Surgery Doing business as

Part of

Central Arkansas Orthodontic Associates LLC

Locations

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1053703249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 TALLEY RD",
            "address_2": "SUITE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722048032",
            "telephone_number": "501-781-2777",
            "fax_number": "501-781-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 SPRINGHILL RD",
            "address_2": "SUITE 1",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720197552",
            "telephone_number": "501-408-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXPM ORAL SURGERY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARK L. DAKE, DDS, MSD AND BRYAN C. HILLER, DMD, MS ORTHODONTIC ASSOCI",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "HILLER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "501-781-2777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Bryant, AR
• Providers in Bryant, AR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.