Mazen Duraini, MD, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

27773 Issued in TX

Practice address

1850 Keller Pkwy
Suite #102
Keller, TX 76248-3706

Phone

(817) 431-9566

Fax

(817) 337-8687

NPI assigned

Nov 14, 2007

Sex

Male

Sole proprietor

No

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 Oct 1, 2013 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Texas Maxillofacial Surgery, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Keller, TX
  • NPI 1437565934
  NPD (past) Authorized official
• Aesthetic Oral & Facial Surgical Center of the Southwest, PC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Keller, TX
  • NPI 1790778314
  NPD (past)

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1457532848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 KELLER PKWY",
            "address_2": "SUITE #102",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483706",
            "telephone_number": "817-431-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 KELLER PKWY",
            "address_2": "SUITE #102",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483706",
            "telephone_number": "817-431-9566",
            "fax_number": "817-337-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAINI",
        "first_name": "MAZEN",
        "name_prefix": "Dr.",
        "credential": "MD, DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "27773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlynn Ann Drewes
• Natalie Driver
• Alyssa Dudley
• Tommy Brent Duncan, MD
• Tracy Elaine Dunn, MA, LPC-A
• Teddy Paul Dyer Jr., D.D.S.
• Eastland Memorial Hospital District
• Gennie Eaton
• Ebd Bemc Burleson, LLC
• Mara B Edmunds, MA, EMDR, LMFTA

• All providers in Keller, TX
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.