NPIMap

Organization Active NPI

Brett Shirley DDS MD PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Nacogdoches, TX
National Provider Identifier
1891264024
Registry record updated Nov 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
BRETT SHIRLEY DDS MD PLLC
Practice address
4800 NE Stallings Dr Ste 113
Nacogdoches, TX 75965-1250
Phone
(936) 657-0120
Fax
(936) 305-5322
NPI assigned
Nov 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2018

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

Authorized official

Name
Dr. Brett Shirley, DDS MDNPI 1467624973
Title
Owner
Phone
(936) 305-5155

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 Primary

Addresses

Primary practice location

4800 NE Stallings Dr Ste 113
Nacogdoches, TX 75965-1250

Mailing address

4800 NE Stallings Dr Ste 113
Nacogdoches, TX 75965-1250
Phone (936) 657-0120

Other names 1

  • Piney Woods Oral and Maxillofacial Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

4800 NE Stallings Dr
Ste 113
Nacogdoches, TX 75965
Phone (936) 305-5155

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1891264024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 NE STALLINGS DR STE 113",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651250",
            "telephone_number": "936-657-0120",
            "fax_number": "936-305-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 NE STALLINGS DR STE 113",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651250",
            "telephone_number": "936-657-0120",
            "fax_number": "936-305-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT SHIRLEY DDS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "SHIRLEY",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-305-5155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Piney Woods Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; 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.