NPIMap

Organization Active NPI

Park Forest Oral and Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Arlington, TX
National Provider Identifier
1790910776
Registry record updated May 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
24439 Issued in TX
Legal business name
PARK FOREST ORAL AND MAXILLOFACIAL SURGERY
Practice address
2304 W Interstate 20
150
Arlington, TX 75254-1674
Phone
(817) 466-8080
Fax
(817) 466-8082
NPI assigned
May 20, 2009
Last updated
May 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2009

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

Authorized official

Name
Dr. Haroon None Ismaili, DDSNPI 1215919337
Title
Owner
Phone
(817) 466-8080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 24439 TX Primary

Addresses

Primary practice location

2304 W Interstate 20
150
Arlington, TX 75254-1674

Mailing address

2304 W Interstate 20
150
Arlington, TX 75254-1674
Phone (817) 466-8080

National Provider Directory

National Provider Directory

Locations

2304 W Interstate 20
Ste 150
Arlington, TX 76017
Phone (817) 466-8080

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1790910776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 W INTERSTATE 20",
            "address_2": "150",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "752541674",
            "telephone_number": "817-466-8080",
            "fax_number": "817-466-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 W INTERSTATE 20",
            "address_2": "150",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "752541674",
            "telephone_number": "817-466-8080",
            "fax_number": "817-466-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK FOREST ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "ISMAILI",
        "authorized_official_first_name": "HAROON",
        "authorized_official_middle_name": "NONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-466-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "24439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.