FACIAL AND ORAL SURGERY ASSOCIATES, PLLC


Address: 1625 Saint Louis Ave, Fort Worth, TX 76104-7635
Phone: 8179271325

FACIAL AND ORAL SURGERY ASSOCIATES, PLLC (NPI# 1891918827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1891918827
Entity Type Organization
Organization Name FACIAL AND ORAL SURGERY ASSOCIATES, PLLC
Practice Address 1625 Saint Louis Ave
Fort Worth
TX 76104-7635
Practice Telephone 8179271325
Practice Fax Number 8179271497
Mailing Telephone 8179271325
Mailing Fax Number 8179271497
Enumeration Date 2007-04-10
Last Update Date 2014-01-15
Authorized Official Name JOHN P. STELLA (PRESIDENT)
Authorized Official Telephone 8179271325
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 1223P0106X Dentist
Specialization: Oral and Maxillofacial Pathology
Dental Providers
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
TX 009690101 05
TX BCBS-BLUE LINK 8116093 01

Office Location

Street Address 1625 SAINT LOUIS AVE
City FORT WORTH
State TX
Zip Code 76104-7635

Providers in the same location

NPI Name Taxonomy Address Enumeration
1831679836 Joshua Hockaday Physician Assistant 1625 Saint Louis Ave, Fort Worth, TX 76104-7635 2018-08-19
1316180821 Siavash Eftekhari Oral & Maxillofacial Surgery 1625 Saint Louis Ave, Fort Worth, TX 76104-7635 2009-04-14

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1669082186 Cvs Pharmacy, Inc. Durable Medical Equipment & Medical Supplies 1115 8th St, Fort Worth, TX 76104 2020-08-10
1992343693 Iris Giove Psychologist John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 2019-12-13
1104480656 Swarnalaxmi Umapathy Student in an Organized Health Care Education/Training Program 900 8th Avenue, Fort Worth, TX 76104 2019-04-30
1881189132 Mega Surgical Assistants LLC Specialist/Technologist, Other 1301pennsylvania, Fort Worth, TX 76104 2018-06-28
1356848899 Tricia Kelly Nurse Practitioner 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 2018-04-11
1952820979 Modern Vein Clinic Internal Medicine 757 8th Avenue, Suite A, Forth Worth, TX 76104 2017-09-11
1790207165 Vanessa Abbood Dietitian, Registered 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 2017-07-07
1922537562 Nicole Marie Tod Student in an Organized Health Care Education/Training Program 1500 S Main Street, Fort Worth, TX 76104 2017-06-07
1770025934 Micah Bonola Chiropractor 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 2016-11-04
1518315894 United Bioscience, LLC. Clinical Medical Laboratory 901 W. Leuda St., B, Fort Worth, TX 76104 2016-05-27
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Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134720337 Texas Wisdom Teeth Specialists Dentist 8409 W Cleburne Rd, Fort Worth, TX 76123-1421 2020-11-04
1699155507 Implants and Oral Surgery, PC Dentist 7217 Hawkins View Dr Ste 200, Fort Worth, TX 76132-3928 2015-06-05
1386058584 Keith Sonneveld Dentist 4421 Oak Park Ln Ste 101, Fort Worth, TX 76109-9541 2014-06-16
1598968190 Herman Kao Dentist 1625 Saint Louis Ave., Fort Worth, TX 76104 2007-06-09
1215130810 Fayette Creed Williams Dentist 1625 Saint Louis Avenue, House Staff & Gme, Fort Worth, TX 76104 2007-06-09
1235353301 Robert Peak Dentist 900 Jerome St, Suite 140, Fort Worth, TX 76104-3945 2007-04-12
1972614071 Spielman Peak Lois & Humes Dds Ms Inc. Dentist 7217 Hawkins View Dr, Suite 200, Fort Worth, TX 76132-3927 2006-08-31
1225070030 Gregory Blaine Scheideman Dentist 4300 Oak Park Ln, Fort Worth, TX 76109-1512 2006-06-13
1508805516 Joseph Carl Cecere Dentist 2501 Ridgmar Plz, Suite 108, Fort Worth, TX 76116-2689 2006-06-05
1538156658 Max Gregory Neill Dentist 4421 Oak Park Ln, Ste 101, Fort Worth, TX 76109-9541 2005-10-04
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Competitor

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City FORT WORTH
Zip Code 76104

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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