NPIMap

Organization Active NPI

University of Texas Southwestern Medical Center at Dallas

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Dallas, TX
National Provider Identifier
1770537508
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone
(214) 645-0624
Fax
(214) 645-0078
NPI assigned
May 19, 2006
Organization subpart
Yes
Parent organization
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Authorized official

Name
Bruce A. Meyer, M.D.
Title
Executive Vice President
Phone
(214) 645-0624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Other identifiers 1

IdentifierTypeStateIssuer
081904701MedicaidTX

Other names 1

  • University of Texas Oral Surgery Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000792 TX Part B Supplier - Clinic/Group Practice 0648188250 Receives reassigned benefits from 5,689 practitioners
46 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 43

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 43

National Provider Directory

National Provider Directory
Tax ID family
Genetic Diagnostic Group79 organizations share this tax ID, including this one
Part of
Genetic Diagnostic Group

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5939 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 645-1919

5939 Harry Hines Blvd
Dallas, TX 75390
Phone (214) 645-3888

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360886400000",
    "number": "1770537508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-02-15",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "214-645-0624",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081904701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of Texas Oral Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.