SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC – Oral and Maxillofacial Surgery (Dentist), NPI 1306839246

SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC is a healthcare provider. based in Ada, Oklahoma. specializing in Oral and Maxillofacial Surgery (Dentist). The NPI Number for SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC is 1306839246

Main info

Organization
Name
SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC
NPI
1306839246
Phone
(580) 332-3010
Address
803 N MONTE VISTA ST
Authorized Official
R. TODD BOONE ORAL SURGEON AND OWNER DDS
Enumeration Date
25 August 2005
Last Update Date
6 May 2014
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

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Provider Addresses for SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC

  • 803, North Monte Vista Street, Ada, Pontotoc County, Oklahoma, 74820, United States

    ADA, OK 748207711

    Phone: (580) 332-3010

    Fax: (580) 332-3010

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 74820)

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Reviews

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Frequently asked questions

Is SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC listed with a National Provider Identifier?
Yes — SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC has NPI 1306839246 on file in the registry.
Is SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC still an active registrant?
SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC carries an active NPI according to the public dataset.
What kind of doctor is SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC?
SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC is associated with Oral and Maxillofacial Surgery (Dentist) in the directory — Clinical services aligned with this taxonomy classification.
Is SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC located near Ada?
SOUTHEAST OKLAHOMA ORAL & MAXILLOFACIAL SURGERY, PC currently maps to Ada, Oklahoma in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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