Abilen Oral and Maxillofacial Surgery Associates PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10328 Issued in TX

Legal business name

ABILEN ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES PLLC

Practice address

4 Hospital Dr
Abilene, TX 79606-5289

Phone

(325) 437-3100

Fax

(325) 437-3199

NPI assigned

Jan 28, 2014

Last updated

Jan 28, 2014By 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

Dr. Joe L Kethley Jr., DDS

Title

Owner

Phone

(325) 437-3100

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1316360373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HOSPITAL DR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065289",
            "telephone_number": "325-437-3100",
            "fax_number": "325-437-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HOSPITAL DR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065289",
            "telephone_number": "325-437-3100",
            "fax_number": "325-437-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABILEN ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "KETHLEY",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-437-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "10328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136335007",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ermias Zenebe Abebe
• Samantha Ann Abels, LMSW, ACM-SW
• Larry D. Abernathy, O. D.
• Abi Counseling, PLLC
• Abifitz, LLC
• Abilene Absolute Recovery Solutions
• Abilene Adult Day Care
• Abilene Advanced Eyecare Inc.
• Abilene Advanced Pain Institute
• Abilene Allergy PLLC

• Oral and Maxillofacial Surgery (Dentist) in Abilene, TX
• Providers in Abilene, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.