Robert Jason Pavelka, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

19346 Issued in TX

Practice address

400 S Cottonwood Dr
Suite B
Richardson, TX 75080-5708

Phone

(972) 231-6661

Fax

(972) 231-3161

NPI assigned

Mar 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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 Apr 19, 2016 through Apr 19, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• North Dallas Family Care PA

  • Contractor
  • Richardson, TX
  • NPI 1720286735
  NPD (past)
• Richardson Oral & Maxillofacial Surgery Associates, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Richardson, TX
  • NPI 1760497291
  NPD (past)

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1700845930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S COTTONWOOD DR",
            "address_2": "SUITE B",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805708",
            "telephone_number": "972-231-6661",
            "fax_number": "972-231-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S COTTONWOOD DR",
            "address_2": "SUITE B",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805708",
            "telephone_number": "972-231-6661",
            "fax_number": "972-231-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVELKA",
        "first_name": "ROBERT",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "19346",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "L8883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Harold Paul, MD
• Robert Keith Paul, OTR
• Jacob Pavel
• Laura Marie Pavelka, ANP-C
• Miro A Pavelka, DDS, MSD
• Rebecca Anne Pawley Downey, LPC, LMFT
• Sydney Pawlichuk
• Cameron Anne Payne
• PC Ipa, LLC
• Peace Home Health Inc.

• Oral and Maxillofacial Surgery (Dentist) in Richardson, TX
• Providers in Richardson, 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 Jul 13, 2007; 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.