Individual provider Active NPI

Corey Paul Yamashita Paulino, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Dallas, TX
National Provider Identifier
1306299037
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
41255 Issued in TX
Practice address
3760 W Northwest Hwy
Dallas, TX 75220-4943
Phone
(480) 262-5802
NPI assigned
Jul 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 41255 TX Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 11643 TN
Dentist 122300000X 100399 CA
Dentist 122300000X 11643 TN

Addresses

Primary practice location

3760 W Northwest Hwy
Dallas, TX 75220-4943

Mailing address

3446 Melvina Dr
Frisco, TX 75033-1052
Phone (480) 262-5802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008004019 TN Practitioner - Maxillofacial Surgery 2163953654 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41255TXMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgical Institute, P.C. Oral and Maxillofacial Surgery CurrentSince Jul 30, 2024 Accepting new patients
Oral Surgery Associates of North Texas, PC Oral and Maxillofacial Surgery PastSince Jun 8, 2025 Accepting new patients
Oral Surgical Institute, P.C. PastSince Jul 30, 2024 Accepting new patients

Locations

125 Cool Springs Blvd
Ste 120
Franklin, TN 37067
Phone (615) 778-0902

500 28th Ave N
Ste 100
Nashville, TN 37209
Phone (615) 329-4401

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1306299037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3446 MELVINA DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750331052",
            "telephone_number": "480-262-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 W NORTHWEST HWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752204943",
            "telephone_number": "480-262-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULINO",
        "first_name": "COREY PAUL",
        "middle_name": "YAMASHITA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-18",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "41255",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "11643",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100399",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.