Kovach Oral Surgery, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

23925 Issued in TX

Legal business name

KOVACH ORAL SURGERY, PLLC

Practice address

4969 E Interstate 20 Service Rd N
Willow Park, TX 76087-3220

Phone

(817) 441-5000

Fax

(817) 441-5003

NPI assigned

Aug 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Todd A Kovach, DDS, MDNPI 1255570040

Title

Managing Member

Phone

(817) 441-5000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Todd Austin Kovach, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Willow Park, TX
  • NPI 1255570040
  NPD (past) Authorized official

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488499200000",
    "number": "1962888149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4969 E INTERSTATE 20 SERVICE RD N",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760873220",
            "telephone_number": "817-441-5000",
            "fax_number": "817-441-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4969 E INTERSTATE 20 SERVICE RD N",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760873220",
            "telephone_number": "817-441-5000",
            "fax_number": "817-441-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOVACH ORAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-10",
        "last_updated": "2017-03-03",
        "status": "A",
        "authorized_official_last_name": "KOVACH",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-441-5000",
        "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": "TX",
            "license": "23925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nusrat Ali Khan, M.D.
• Ashley King
• Reagan Lynn Kinnear, PH.D.
• Brittany Leann Kirk, LPC
• Carly Jonina Klassen, D.D.S.
• Todd Austin Kovach, DDS, MD
• Kropski Services LLC
• Elizabeth Leddy Laborde, DDS
• Carla Lambert
• Laurenzo Services Inc

• Oral and Maxillofacial Surgery (Dentist) in Willow Park, TX
• Providers in Willow Park, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; 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.