Heritage Oral and Facial Surgery, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

21840 Issued in TX

Legal business name

HERITAGE ORAL AND FACIAL SURGERY, PLLC

Practice address

1237 County Road 197
Jonesboro, TX 76538-1207

Phone

(254) 300-8804

Fax

(254) 350-2868

NPI assigned

Jan 15, 2016

Last updated

Jan 15, 2016By 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. Joseph Dylan Bowles, DDSNPI 1922085331

Title

Manager

Phone

(910) 922-9644

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.

• Joseph Dylan Bowles, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Cleburne, TX
  • NPI 1922085331
  Authorized official Same address or phone

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452816000000",
    "number": "1588021950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 COUNTY ROAD 197",
            "city": "JONESBORO",
            "state": "TX",
            "postal_code": "765381207",
            "telephone_number": "254-300-8804",
            "fax_number": "254-350-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 COUNTY ROAD 197",
            "city": "JONESBORO",
            "state": "TX",
            "postal_code": "765381207",
            "telephone_number": "254-300-8804",
            "fax_number": "254-350-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE ORAL AND FACIAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A",
        "authorized_official_last_name": "BOWLES",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "DYLAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "910-922-9644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "21840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonesboro Independent School District
• Shelia Joy Schwalbe
• Texas Dental Implant Center

• Oral and Maxillofacial Surgery (Dentist) in Jonesboro, TX
• Providers in Jonesboro, 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 15, 2016; 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.