East Austin Oral Surgery PLLC

Primary specialty

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

Legal business name

EAST AUSTIN ORAL SURGERY PLLC

Practice address

2832 E MLK Blvd Apt 102
Austin, TX 78702-1504

Phone

(210) 846-3890

NPI assigned

May 25, 2023

Last updated

Jun 14, 2024By 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

Matthew Largent, MD DDSNPI 1497938468

Title

Owner

Phone

(210) 846-3890

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew C. Largent, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Austin, TX
  • NPI 1497938468
  NPD Authorized official

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1215629340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 WESTVIEW DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2832 E MLK BLVD APT 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787021504",
            "telephone_number": "210-846-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST AUSTIN ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "LARGENT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-846-3890",
        "authorized_official_credential": "MD DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Austin, TX
• Providers in Austin, 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 Jun 14, 2024; 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.