Aesthetic Oral & Facial Surgical Center of the Southwest, PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

17519 Issued in TX

Legal business name

AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC

Practice address

1850 Keller Pkwy
Suite 102
Keller, TX 76248-3706

Phone

(817) 431-9566

Fax

(817) 337-8687

NPI assigned

Aug 30, 2005

Last updated

Aug 22, 2020By 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

William J Starck, DDS

Title

President

Phone

(817) 431-9566

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Mazen Duraini, MD, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Keller, TX
  • NPI 1457532848
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790778314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 KELLER PKWY",
            "address_2": "SUITE 102",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483706",
            "telephone_number": "817-431-9566",
            "fax_number": "817-337-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 KELLER PKWY",
            "address_2": "SUITE 102",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483706",
            "telephone_number": "817-431-9566",
            "fax_number": "817-337-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC ORAL & FACIAL SURGICAL CENTER OF THE SOUTHWEST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STARCK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-431-9566",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "17519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adjoining Hands HCS, Inc.
• Advanced Endodontics of DFW (Advanced Endodontics of Texas)
• Advanced Neuromuscular Performance & Physical Therapy LLC
• Advanced Spine Solutions PA
• Aegis Group Practice LLC
• Gertrude Agyekum, PHARMD
• Aileen Wainwright, LCSW Inc. (Keller Heights Counseling & Wellness)
• Airy Choi DMD, PLLC (Oasis Family Dentistry)
• Amy Akabue-Isom, LPC
• Christopher Lucas Alamilla, DC

• Oral and Maxillofacial Surgery Clinic/Center in Keller, TX
• Providers in Keller, 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 22, 2020; 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.