Zachary T Legan, DDS, MD

Primary specialty

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

License

R6819 Issued in TX

Practice address

1701 Moores LN
Texarkana, TX 75503-1894

Phone

(903) 794-3331

NPI assigned

Apr 30, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 13, 2018 through Mar 13, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oral and Maxillofacial Surgeons of Northeast Texas, P. a.

  • Oral and Maxillofacial Surgery (Dentist)
  • Texarkana, TX
  • NPI 1902052095
  NPD (past)
• Oral and Maxillofacial Surgeons of Northeast Texas, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Texarkana, TX
  • NPI 1538560362
  NPD (past)

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

{
    "created_epoch": "1304121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578096000000",
    "number": "1295026813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031894",
            "telephone_number": "903-794-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031894",
            "telephone_number": "903-794-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3605 NE Loop 286 Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Paris",
            "state": "TX",
            "postal_code": "754605045",
            "country_code": "US",
            "telephone_number": "903-785-2541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGAN",
        "first_name": "ZACHARY",
        "middle_name": "T",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-30",
        "last_updated": "2020-01-04",
        "certification_date": "2020-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "R6819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leary Independent School District
• Katie Marie Leatherwood, LP
• Lauren Leblanc-Rasberry, DNP, NNP-BC
• Jason Z Lee, MD
• David Kumba Lefors, CPO
• Andrew Ellis Legrand, DO
• Stacy L Leonard, MD
• Emily Lester
• Bambi Ashanti Levingston, OTR
• Lewis C Cook MD PA

• Oral & Maxillofacial Surgery (D.M.D.) in Texarkana, TX
• Providers in Texarkana, 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 Jan 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.