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ORAL & MAXILLOFACIAL SURGERY OF TYLER, PC
NPI 1154493922
Dentist - Oral and Maxillofacial Surgery in Tyler, TX

Active since November 15, 2006
700 OLYMPIC PLAZA CIR STE 412, TYLER, TX 75701(903) 595-5186(903) 595-5240 Get Directions Write a Review

NPPES record last updated: July 16, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Oral & Maxillofacial Surgery Of Tyler, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ORAL & MAXILLOFACIAL SURGERY OF TYLER, PC (NPI 1154493922), doing business as Olympic Plaza Oral & Maxillofacial Surgery Assoc., is a healthcare organization registered as an oral and maxillofacial surgery in Tyler, Texas and active in the NPI registry since November 2006. The organization lists Jerri G. Grace, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1154493922
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameORAL & MAXILLOFACIAL SURGERY OF TYLER, PC
Location Address700 OLYMPIC PLAZA CIR STE 412Tyler, TX 75701-1952
Mailing Address700 Olympic Plaza Cir Ste 412Tyler, TX 75701-1952 · (903) 595-5186 · Fax (903) 595-5240
Phone(903) 595-5186
Fax(903) 595-5240
Organization SubpartNo
Authorized OfficialJerri G. GraceOffice Manager · (903) 595-5186
Enumeration DateNovember 15, 2006
Last NPPES UpdateJuly 16, 2008
✔ NPI 1154493922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in TX · 10456 & 17107
Definition
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.
700 OLYMPIC PLAZA CIR STE 412, Tyler, TX 75701
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Other Names 1

Former Legal Business NameOlympic Plaza Oral & Maxillofacial Surgery Assoc.

Other Identifiers 3

Medicare ID-Type Unspecified0808586-01TX
Medicaid080858601TX
Medicare ID-Type Unspecified00604ETX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRIAN HENRY STONE D.D.S., M.D.
Dentist (Oral and Maxillofacial Surgery)
700 OLYMPIC PLAZA CIR STE 412
TYLER, TX 75701
Smith County (903) 595-5186
DENNIS ROSS SPENCE D.D.S., M.S.
Dentist (Oral and Maxillofacial Surgery)
700 OLYMPIC PLAZA CIR STE 412
TYLER, TX 75701
Smith County (903) 595-5186

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Oral & Maxillofacial Surgery Of Tyler, PC's NPI number?

The NPI number for Oral & Maxillofacial Surgery Of Tyler, PC is 1154493922. It was assigned to this organization in the NPPES registry on November 15, 2006. The provider was formerly known as Olympic Plaza Oral & Maxillofacial Surgery Assoc..

Where is Oral & Maxillofacial Surgery Of Tyler, PC located?

Oral & Maxillofacial Surgery Of Tyler, PC is located at 700 Olympic Plaza Cir Ste 412, Tyler, TX 75701. The listed phone number is (903) 595-5186.

What is Oral & Maxillofacial Surgery Of Tyler, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Oral & Maxillofacial Surgery Of Tyler, PC was last updated on July 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.