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STONE ORAL FACIAL SURGERY GROUP PLLC NPI 1912258740


NPI Information

NPI: 1912258740
Provider Name: STONE ORAL FACIAL SURGERY GROUP PLLC

Doing Business As: SOUTHERN SURGICAL ARTS

Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
2550 ELKTON TRL
TYLER, TX
ZIP 75703
Phone: (903) 534-1414
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STONE ORAL FACIAL SURGERY GROUP PLLC is an oral and maxillofacial surgery dentist in Tyler, TX. The provider is an oral and maxillofacial surgery dentist specialized in 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. STONE ORAL FACIAL SURGERY GROUP PLLC NPI is 1912258740. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southern Surgical Arts.

The provider's business location address is:

2550 ELKTON TRL
TYLER, TX
ZIP 75703-594
Phone: (903) 534-1414
Fax: (903) 534-1415

The provider's authorized official is Charles G Stone .
The authorized official title is Owner/officer and has the following contact phone number (903) 534-1414.

The enumeration date for this NPI number is 9/19/2012 and was last updated on 12/26/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11896953-06MEDICAIDTEXAS
23099020-01MEDICAIDTEXAS
3260458MEDICARE PINTEXAS
4260495YLHJMEDICARE PINTEXAS
51206989-09MEDICAIDTEXAS
61305898-08MEDICAIDTEXAS
71305898-09MEDICAIDTEXAS
83126690-03MEDICAIDTEXAS
91206989-08MEDICAIDTEXAS
102032740-06MEDICAIDTEXAS
11260510LYHJMEDICARE PINTEXAS
12260507YLHJMEDICARE PINTEXAS
132032740-07MEDICAIDTEXAS
14260516YLHJMEDICARE PINTEXAS
151896953-05MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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