NPIMap

Organization Active NPI

Permian Basin Oral Surgery & Dental Implant Center

Doing business as Permian Basin Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Odessa, TX
National Provider Identifier
1922288539
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
PERMIAN BASIN ORAL SURGERY & DENTAL IMPLANT CENTER
Doing business as
Permian Basin Oral Surgery
Practice address
8101 Dorado Dr
Odessa, TX 79765-8533
Phone
(432) 333-6585
NPI assigned
Nov 12, 2007
Last updated
Jul 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
Dr. Kevin Eric Porter, D.D.S. M.D.NPI 1225181746
Title
President
Phone
(432) 333-6585

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) 1223S0112X Primary

Addresses

Primary practice location

8101 Dorado Dr
Odessa, TX 79765-8533

Mailing address

8101 Dorado Dr
Odessa, TX 79765-8533
Phone (432) 333-6585

Other names 1

  • Permian Basin Oral Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

8101 Dorado Dr
Odessa, TX 79765
Phone (432) 333-6585

Practitioners & affiliated clinicians

Practitioners 5

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": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1922288539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 DORADO DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658533",
            "telephone_number": "432-333-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 DORADO DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797658533",
            "telephone_number": "432-333-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERMIAN BASIN ORAL SURGERY & DENTAL IMPLANT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "432-333-6585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S. M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Permian Basin Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.