EAST TEXAS ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC.
NPI 1952459307
Dentist - Oral and Maxillofacial Surgery in Longview, TX

Q: What is East Texas Oral & Maxillofacial Surgery Associates Inc.'s specialty?

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

Active since January 08, 2007

3004 H G MOSELEY PKWY, LONGVIEW, TX 75605(903) 758-3444(903) 758-1967 Get Directions Write a Review

NPPES record last updated: March 20, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About East Texas Oral & Maxillofacial Surgery Associates Inc. NPPES

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

EAST TEXAS ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC. (NPI 1952459307) is a healthcare organization registered as an oral and maxillofacial surgery in Longview, Texas and active in the NPI registry since January 2007. The organization lists Charlotte Marie Wilks, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1952459307

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameEAST TEXAS ORAL & MAXILLOFACIAL SURGERY ASSOCIATES INC.

Location Address3004 H G MOSELEY PKWYLongview, TX 75605-2948

Mailing Address3004 H G Moseley PkwyLongview, TX 75605-2948 · (903) 758-3444 · Fax (903) 758-1967

Phone(903) 758-3444

Fax(903) 758-1967

Organization SubpartNo

Authorized OfficialCharlotte Marie WilksOffice Manager · (903) 758-3444

Enumeration DateJanuary 8, 2007

Last NPPES UpdateMarch 20, 2012

✔ NPI 1952459307 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 · 10700

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.

3004 H G MOSELEY PKWY, Longview, TX 75605

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Other Identifiers 3

Medicaid111312801TX

Medicaid111312802TX

Medicare UPIN00K83QTX

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include DentaQuest USA Insurance Company, Inc..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)

East Texas Oral & Maxillofacial Surgery Associates Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to East Texas Oral & Maxillofacial Surgery Associates Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

James Mack, DDS

Maxillofacial Surgery

NPI 1073606281

3004 HG MOSLEY PKWY
Longview, TX 75605

(903) 758-3444

✔ PECOS✔ Accepts MedicareSame address

Simon Mack, D.D.S.

Dentist

NPI 1639676166

3004 H.G. MOSLEY PKWY
Longview, TX 75605

(903) 758-3444

✔ PECOS✔ Accepts Medicare4.1 mi

Nathan Yang

Dentist

NPI 1679935076

3004 H G MOSLEY PKWY
Longview, TX 75605

(903) 758-3444

✔ PECOS✔ Accepts Medicare4.1 mi

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 East Texas Oral & Maxillofacial Surgery Associates Inc.'s NPI number?

The NPI number for East Texas Oral & Maxillofacial Surgery Associates Inc. is 1952459307. It was assigned to this organization in the NPPES registry on January 8, 2007.

Where is East Texas Oral & Maxillofacial Surgery Associates Inc. located?

East Texas Oral & Maxillofacial Surgery Associates Inc. is located at 3004 H G Moseley Pkwy, Longview, TX 75605. The listed phone number is (903) 758-3444.

What is East Texas Oral & Maxillofacial Surgery Associates Inc.'s specialty?

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

Is East Texas Oral & Maxillofacial Surgery Associates Inc. enrolled in Medicare?

Yes. East Texas Oral & Maxillofacial Surgery Associates Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East Texas Oral & Maxillofacial Surgery Associates Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to East Texas Oral & Maxillofacial Surgery Associates Inc., in Dentist and Maxillofacial Surgery. 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, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does East Texas Oral & Maxillofacial Surgery Associates Inc. accept?

Health plans from DentaQuest USA Insurance Company, Inc. list East Texas Oral & Maxillofacial Surgery Associates Inc. 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 East Texas Oral & Maxillofacial Surgery Associates Inc. was last updated on March 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.