Park Cities Oral & Maxillofacial Surgery Assoc. PA

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

L7848 Issued in TX

Legal business name

PARK CITIES ORAL & MAXILLOFACIAL SURGERY ASSOC. PA

Practice address

6140 Sherry Lane
Dallas, TX 75225

Phone

(214) 363-2475

Fax

(214) 528-5510

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William Ralph Phillips, DDS, MD

Title

Owner/Physician

Phone

(214) 363-2475

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520812800000",
    "number": "1174670376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 SHERRY LANE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75225",
            "telephone_number": "214-363-2475",
            "fax_number": "214-528-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 SHERRY LANE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75225",
            "telephone_number": "214-363-2475",
            "fax_number": "214-528-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CITIES ORAL & MAXILLOFACIAL SURGERY ASSOC. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2018-03-12",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RALPH",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "214-363-2475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "L7848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Dallas, TX
• Providers in Dallas, TX by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; 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.