ORAL & MAXILLOFACIAL NETWORK, P.L.L.C.
NPI 1417170655
Dentist - Oral and Maxillofacial Surgery in Fort Worth, TX

NPI Status: Active since April 10, 2007

Contact Information

1500 S MAIN ST
FORT WORTH, TX
ZIP 76104
Phone: (817) 920-6936
Fax: (817) 702-1035

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  • Organization
  • Dentist
  • Oral and Maxillofacial Surgery
  • Accepts Insurance

About ORAL & MAXILLOFACIAL NETWORK, P.L.L.C.

This page provides the complete NPI Profile along with additional information for Oral & Maxillofacial Network, P.l.l.c., a provider established in Fort Worth, Texas operating as a Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1417170655 assigned on April 2007. The practitioner's primary taxonomy code is 1223S0112X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Oral & Maxillofacial Network, P.l.l.c. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Holly Marie Portwood (Chief Operating Officer)

NPI
1417170655
Provider Name
ORAL & MAXILLOFACIAL NETWORK, P.L.L.C.
Entity Type
Organization
Location Address
1500 S MAIN ST FORT WORTH, TX 76104
Location Phone
(817) 920-6936
Location Fax
(817) 702-1035
Mailing Address
1500 S MAIN ST FORT WORTH, TX 76104
Mailing Phone
(817) 920-6936
Mailing Fax
(817) 702-1035
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-10-2007
Last Update Date
07-08-2024
Code Navigator

A dentist like Oral & Maxillofacial Network, P.l.l.c. is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist Oral and Maxillofacial Surgery

Taxonomy Code
1223S0112X
Type
Dental Providers
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11223P0106XDental Providers

Dentist
Oral and Maxillofacial Pathology

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoice) + Vision + Adult Dental - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze (QualChoice) - POS
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Standard Gold - PPO
  • Standard Gold + Vision + Adult Dental - PPO
  • Standard Silver - PPO
  • Standard Silver + Vision + Adult Dental - PPO
  • DentaQuest PPO Pediatric High - PPO
  • DentaQuest PPO Family Basic - PPO
  • DentaQuest PPO Family High - PPO
  • DentaQuest PPO Family Low - PPO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Saver 750 - HMO
  • Molina Gold Saver 750 Plus with Adult Dental and Vision - HMO
  • Molina Gold Saver 750 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • Molina Silver Saver with Four Free PCP Visits - HMO
  • Molina Silver Standard - HMO
  • Wellpoint Essential Bronze 4000 HSA (+ Incentives) - HMO
  • Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
  • Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Catastrophic (+ Incentives) - HMO
  • Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Gold POS 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

HOLLY MARIE PORTWOOD

Authorized Official Title
CHIEF OPERATING OFFICER
Authorized Official Phone
(817) 920-6936

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
180717401MEDICAID (05)TX 
G60225-01OTHER (01)TXTX CHIP DELTA DENTAL
48MZOTHER (01)TXBLUE CROSS BLUE SHIELD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1417170655, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
1
Doubled → 2
Pos 4
7
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
0
Doubled → 0
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 0 → 0 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 2 + 7 + 2 + 7 + 0 + 6 + 1 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1417170655.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Anesthesiology
1500 S MAIN ST, JPS HOSIPITAL, DEPARTMENT OF ANESTHESIOLOGY
FORT WORTH, TX 76104
General Acute Care Hospital
1500 S MAIN ST, PHYSICIAN SERVICES
FORT WORTH, TX 76104
Family Medicine
1500 S MAIN ST, FORT WORTH
FORT WORTH, TX 76104
Family Medicine
1500 S MAIN ST, FAMILY HEALTH CENTER
FORT WORTH, TX 76104
Family Medicine
1500 S MAIN ST, FAMILY MEDICINE CENTER
FORT WORTH, TX 76104
Family Medicine
1500 S MAIN ST
FORT WORTH, TX 76104
Family Medicine
1500 S MAIN ST, DEPT. OF FAMILY MEDICINE
FORT WORTH, TX 76104
Family Medicine
1500 S MAIN ST
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
1500 S MAIN ST
FORT WORTH, TX 76104
Emergency Medicine
1500 S MAIN ST
FORT WORTH, TX 76104
Nurse Practitioner (Family)
1500 S MAIN ST
FORT WORTH, TX 76104
Nurse Practitioner
1500 S MAIN ST
FORT WORTH, TX 76104
Radiology (Diagnostic Radiology)
1500 S MAIN ST
FORT WORTH, TX 76104
Pediatrics
1500 S MAIN ST
FORT WORTH, TX 76104
Nurse Practitioner
1500 S MAIN ST
FORT WORTH, TX 76104
Pediatrics
1500 S MAIN ST
FORT WORTH, TX 76104
Dermatology
1500 S MAIN ST
FORT WORTH, TX 76104
Internal Medicine (Gastroenterology)
1500 S MAIN ST
FORT WORTH, TX 76104
Family Medicine
1500 S MAIN ST
FORT WORTH, TX 76104
Nurse Practitioner (Neonatal)
1500 S MAIN ST
FORT WORTH, TX 76104

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417170655, enumerated as an "organization" on April 10, 2007.

The provider is located at 1500 S MAIN ST FORT WORTH, TX 76104 and the phone number is (817) 920-6936.

Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.