SOUTHEASTERN ORAL-MAXILLOFACIAL AND COSMETIC SURGERY CENTER
NPI 1275755860
Dentist - Oral and Maxillofacial Surgery in Dothan, AL
About Southeastern Oral-maxillofacial And Cosmetic Surgery Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHEASTERN ORAL-MAXILLOFACIAL AND COSMETIC SURGERY CENTER (NPI 1275755860) is a healthcare organization registered as an oral and maxillofacial surgery in Dothan, Alabama and active in the NPI registry since May 2007. The organization lists Karen Bradshaw, Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southeastern Oral-maxillofacial And Cosmetic Surgery Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Southeastern Oral-Maxillofacial And Cosmetic Surgery Center, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Southeastern Oral-Maxillofacial And Cosmetic Surgery Center's NPI number?
The NPI number for Southeastern Oral-Maxillofacial And Cosmetic Surgery Center is 1275755860. It was assigned to this organization in the NPPES registry on May 3, 2007.
Where is Southeastern Oral-Maxillofacial And Cosmetic Surgery Center located?
Southeastern Oral-Maxillofacial And Cosmetic Surgery Center is located at 216 Healthwest Dr, Dothan, AL 36303. The listed phone number is (334) 792-2880.
What is Southeastern Oral-Maxillofacial And Cosmetic Surgery Center's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Southeastern Oral-Maxillofacial And Cosmetic Surgery Center enrolled in Medicare?
Yes. Southeastern Oral-Maxillofacial And Cosmetic Surgery Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southeastern Oral-Maxillofacial And Cosmetic Surgery Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Oral Surgery, reassign their Medicare billing to Southeastern Oral-Maxillofacial And Cosmetic Surgery Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southeastern Oral-Maxillofacial And Cosmetic Surgery Center accept?
Health plans from Ambetter Health, Ambetter of Alabama and Ambetter of Tennessee list Southeastern Oral-Maxillofacial And Cosmetic Surgery Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southeastern Oral-Maxillofacial And Cosmetic Surgery Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Southeastern Oral-Maxillofacial And Cosmetic Surgery Center · NPI 1275755860
Oral and Maxillofacial Surgery organization in Dothan, Alabama. Organization record, active in the CMS NPPES registry since May 3, 2007.
## Identity
- **NPI:** 1275755860 (Entity type: Organization)
- **Enumerated:** May 3, 2007
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **Organization subpart:** No
- **Authorized official:** Karen Bradshaw, ADMINISTRATOR
## Practice location
- **Address:** 216 HEALTHWEST DR, Dothan, AL 36303-1942
- **Phone:** (334) 792-2880 · **Fax:** (334) 792-9336
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Oral Surgery) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1275755860) · Data from the CMS NPPES public registry.