Richardson Oral & Maxillofacial Surgery Associates, Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11521 Issued in TX

Legal business name

RICHARDSON ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, INC.

Practice address

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

Phone

(972) 231-6661

Fax

(972) 231-3161

NPI assigned

Jul 31, 2006

Last updated

Sep 15, 2008By 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

Miro A. Pavelka Jr., D.D.S.NPI 1154447415

Title

Owner/President

Phone

(972) 231-6661

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Miro A Pavelka, DDS, MSD

  • Oral and Maxillofacial Surgery (Dentist)
  • Richardson, TX
  • NPI 1154447415
  NPD (past) Authorized official
• Robert Jason Pavelka, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Richardson, TX
  • NPI 1700845930
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1760497291",
    "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": {
        "organization_name": "RICHARDSON ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "PAVELKA",
        "authorized_official_first_name": "MIRO",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "972-231-6661",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "11521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richardson Independent School District
• Richardson Integrated Health (Richardson Pain and Wellness)
• Richardson Interventional Pain Procedure Center, LLC
• Richardson Mimosa Medical Center (First Choice Emergency Room)
• Richardson Nursing and Rehab Center, LLC
• Richardson Oral Surgery and Implant Center PLLC
• Richardson Pediatric Associates
• Richardson Physical Therapy Clinic
• Richardson Physician Alliance
• Richardson Primarycare Clinic LLC

• 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 Sep 15, 2008; 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.