Active NPI
Thomas C Vaughan III, DDS, MD
- Oral and Maxillofacial Surgery (Dentist)
- Fayetteville, AR
National Provider Identifier
1750796322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 4014
- Practice address
- 2025 N Green Acres Rd
Fayetteville, AR 72703-2619 - Phone
- (479) 202-8666
- Fax
- (844) 315-4115
- NPI assigned
- Jun 23, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 4014 | AR | Primary |
Addresses
Primary practice location
2025 N Green Acres Rd
Fayetteville, AR 72703-2619
Mailing address
2025 N Green Acres Rd
Fayetteville, AR 72703-2619
Phone (479) 202-8666
Other practice location 1
2300 S 58th St Ste C
Fort Smith, AR 72903-3825
Phone (479) 202-8666
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200629003140 | TX | Practitioner - Oral Surgery | 2365741428 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4014 | AR | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osct, PLLC | Oral and Maxillofacial Surgery | Current | Accepting new patients |
| University of Frida | Past | Accepting new patients |
Locations
2903 N FM 1417
Sherman, TX 75092
Phone (903) 868-1370
Organizations & group practices 2
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.
-
- Oral & Maxillofacial Surgery (D.M.D.)
- Sherman, TX
- NPI 1285817379
Oral and Maxillofacial Surgery
-
- Dentist
- Gainesville, FL
- NPI 1629429204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763337600000",
"number": "1750796322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 N GREEN ACRES RD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727032619",
"telephone_number": "479-202-8666",
"fax_number": "844-315-4115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025 N GREEN ACRES RD",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727032619",
"telephone_number": "479-202-8666",
"fax_number": "844-315-4115"
}
],
"practiceLocations": [
{
"address_1": "2300 S 58th St Ste C",
"address_purpose": "LOCATION",
"city": "Fort Smith",
"state": "AR",
"postal_code": "729033825",
"country_code": "US",
"telephone_number": "479-202-8666",
"fax_number": "844-315-4115",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VAUGHAN",
"first_name": "THOMAS",
"middle_name": "C",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DDS, MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-23",
"last_updated": "2025-11-17",
"certification_date": "2025-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "AR",
"license": "4014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.