Jason Nicholas Stamboulieh, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

21740 - DENTAL Issued in TX

Practice address

2500 Legacy Dr
Suite 230
Frisco, TX 75034-5983

Phone

(214) 385-1476

NPI assigned

Jun 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Dr Stamboulieh Oral and Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Frisco, TX
  • NPI 1568625721
  NPD (past) Authorized official

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1770787368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6200",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750350228",
            "telephone_number": "214-385-1476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 LEGACY DR",
            "address_2": "SUITE 230",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345983",
            "telephone_number": "214-385-1476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMBOULIEH",
        "first_name": "JASON",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "21740 - DENTAL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Frisco, TX
• Providers in Frisco, TX by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.