Organization Active NPI

Southlake Center for Oral and Reconstructive Surgery, PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Southlake, TX
National Provider Identifier
1912811977
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
David SchwitzerNPI 1285167544
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)CodeLicenseStatePrimary
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.

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.

Verify at the official NPI Registry.