Active NPI
Southlake Center for Oral and Reconstructive Surgery, PLLC
- Oral & Maxillofacial Surgery (D.M.D.)
- Southlake, TX
National Provider Identifier
1912811977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- Legal business name
- SOUTHLAKE CENTER FOR ORAL AND RECONSTRUCTIVE SURGERY, PLLC
- Practice address
- 1480 Corporate Cir Ste 180
Southlake, TX 76092-5964 - Phone
- (516) 680-0337
- NPI assigned
- Sep 29, 2026
- Last updated
- Sep 29, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Schwitzer
- Title
- Manager
- Phone
- (516) 680-0337
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | NU | Primary |
Addresses
Primary practice location
1480 Corporate Cir Ste 180
Southlake, TX 76092-5964
Mailing address
1480 Corporate Cir Ste 180
Southlake, TX 76092-5964
Practitioners & affiliated clinicians
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.
-
- Oral & Maxillofacial Surgery (D.M.D.)
- Southlake, TX
- NPI 1285167544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790640000000",
"number": "1912811977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1480 CORPORATE CIR STE 180",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760925964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1480 CORPORATE CIR STE 180",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760925964",
"telephone_number": "516-680-0337"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHLAKE CENTER FOR ORAL AND RECONSTRUCTIVE SURGERY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-29",
"last_updated": "2026-09-29",
"certification_date": "2026-09-29",
"status": "A",
"authorized_official_last_name": "SCHWITZER",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "516-680-0337"
},
"taxonomies": [
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.