NPIMap

Organization Active NPI

Central Texas Oral Surgery Assc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Austin, TX
National Provider Identifier
1114018124
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
18515 Issued in TX
Legal business name
CENTRAL TEXAS ORAL SURGERY ASSC.
Practice address
3200 Red River
#400
Austin, TX 78705
Phone
(512) 320-1640
Fax
(512) 320-1643
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Franklin Samuel Bonasso, DDSNPI 1558471698
Title
Oral Surgeon
Phone
(512) 320-1640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 18515 TX Primary

Addresses

Primary practice location

3200 Red River
#400
Austin, TX 78705

Mailing address

3200 Red River
#400
Austin, TX 78705
Phone (512) 320-1640

Other identifiers 2

IdentifierTypeStateIssuer
0015705OtherTXASSURANT
D18515OtherTXBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

3200 Red River St
Ste 400
Austin, TX 78705
Phone (512) 320-1640

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114018124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 RED RIVER",
            "address_2": "#400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78705",
            "telephone_number": "512-320-1640",
            "fax_number": "512-320-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 RED RIVER",
            "address_2": "#400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78705",
            "telephone_number": "512-320-1640",
            "fax_number": "512-320-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS ORAL SURGERY ASSC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BONASSO",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "512-320-1640",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "18515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSURANT",
            "identifier": "0015705",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "D18515",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.