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SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC
NPI 1306839246
Dentist - Oral and Maxillofacial Surgery in Ada, OK

Active since August 25, 2005
803 N MONTE VISTA ST, ADA, OK 74820(580) 332-3010(580) 332-3010 Get Directions Write a Review

NPPES record last updated: May 6, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southeast Oklahoma Oral & Maxillofacial Surgery, Pc NPPES

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

SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC (NPI 1306839246) is a healthcare organization registered as an oral and maxillofacial surgery in Ada, Oklahoma and active in the NPI registry since August 2005. The organization lists R. Todd Boone, Oral Surgeon And Owner, as its authorized official.

NPPES Registry Identity

NPI1306839246
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameSOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC
Location Address803 N MONTE VISTA STAda, OK 74820-7711
Mailing Address803 N Monte Vista StAda, OK 74820-7711 · (580) 332-3010 · Fax (580) 332-3010
Phone(580) 332-3010
Fax(580) 332-3010
Organization SubpartNo
Authorized OfficialR. Todd BooneOral Surgeon And Owner · (580) 332-3010
Enumeration DateAugust 25, 2005
Last NPPES UpdateMay 6, 2014
✔ NPI 1306839246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
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.
803 N MONTE VISTA ST, Ada, OK 74820
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Other Identifiers 6

Other444583300003OK · Bcbs
Other787600OK · United Concordia
Medicare PIN200522080OK
Medicare UPINU10180
Medicaid100112550AOK
Other444583300004OK · Bcbs

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 3

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

NOVA ORAL SURGERY LLC
Dentist (Oral and Maxillofacial Surgery)
803 N MONTE VISTA ST
ADA, OK 74820
Pontotoc County (580) 332-3010
DR. HANS CHARLES IGOU D.D.S.
Dentist
803 N MONTE VISTA ST
ADA, OK 74820
Pontotoc County (580) 332-3010
DR. RICHARD TODD BOONE DDS
Dentist (Oral and Maxillofacial Surgery)
803 N MONTE VISTA ST
ADA, OK 74820
Pontotoc County (580) 332-3010

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 Southeast Oklahoma Oral & Maxillofacial Surgery, PC's NPI number?

The NPI number for Southeast Oklahoma Oral & Maxillofacial Surgery, PC is 1306839246. It was assigned to this organization in the NPPES registry on August 25, 2005.

Where is Southeast Oklahoma Oral & Maxillofacial Surgery, PC located?

Southeast Oklahoma Oral & Maxillofacial Surgery, PC is located at 803 N Monte Vista St, Ada, OK 74820. The listed phone number is (580) 332-3010.

What is Southeast Oklahoma Oral & Maxillofacial Surgery, 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 Southeast Oklahoma Oral & Maxillofacial Surgery, PC was last updated on May 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.