Thomas K. W. Draper, DMD. MD, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

24789 Issued in TX

Legal business name

THOMAS K. W. DRAPER, DMD. MD, PLLC

Practice address

215 S FM 548
Suite C
Forney, TX 75126-4129

Phone

(469) 689-0704

Fax

(469) 689-0709

NPI assigned

Jan 17, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Thomas K DraperNPI 1306018320

Title

Owner

Phone

(469) 689-0704

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Trinity Valley Oral Surgery & Dental Implant Center Other name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas K. W. Draper, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Forney, TX
  • NPI 1306018320
  NPD (past) Authorized official
• Reed P Gibbins, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Forney, TX
  • NPI 1851566988
  NPD (past)

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

{
    "created_epoch": "1326758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345680000000",
    "number": "1700157146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S FM 548",
            "address_2": "SUITE C",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751264129",
            "telephone_number": "469-689-0704",
            "fax_number": "469-689-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S FM 548",
            "address_2": "SUITE C",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751264129",
            "telephone_number": "469-689-0704",
            "fax_number": "469-689-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS K. W. DRAPER, DMD. MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-17",
        "last_updated": "2012-08-23",
        "status": "A",
        "authorized_official_last_name": "DRAPER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-689-0704",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "24789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1306018320",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206992419",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY TPI MEDICAID",
            "identifier": "288152601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OPT OUT PTAN",
            "identifier": "OPT0005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Valley Oral Surgery & Dental Implant Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Forney, TX
• Providers in Forney, 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 Aug 23, 2012; 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.