Greater Beaumont Oral & Maxillofacial Surgery, PA

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

29763 Issued in TX

Legal business name

GREATER BEAUMONT ORAL & MAXILLOFACIAL SURGERY, PA

Practice address

2929 Calder St Ste 302
Beaumont, TX 77702-1831

Phone

(409) 832-2532

Fax

(409) 832-3055

NPI assigned

Jun 20, 2014

Organization subpart

No

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

Authorized official

Name

Prashanth RaviNPI 1356577175

Title

Director

Phone

(231) 392-2500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Prashanth Ravi, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Pasadena, TX
  • NPI 1356577175
  NPD Authorized official
• Edward F Rod Jr., D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Beaumont, TX
  • NPI 1174521843
  NPD (past)

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1790199461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 CALDER ST STE 302",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021831",
            "telephone_number": "409-832-2532",
            "fax_number": "409-832-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 CALDER ST STE 302",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021831",
            "telephone_number": "409-832-2532",
            "fax_number": "409-832-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BEAUMONT ORAL & MAXILLOFACIAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "RAVI",
        "authorized_official_first_name": "PRASHANTH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "231-392-2500"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "29763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Brett Graffagnino, LSA, CSFA
• Lacey N Graffagnino, LSA
• Clancie Calais Grant, RPH
• Shawn Rooney Gray, MSN
• Great American Scooter Company Golden Triangle LLC
• Greater Houston Emergency Physicians PLLC
• Greater Texas Orthopedic Associates, PLLC
• Michael J Grecula, M.D.
• Catalina Green
• Chrystal Green, RN

• Oral and Maxillofacial Surgery Clinic/Center in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.