MEDICARE: COREY PAUL YAMASHITA PAULINO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	41255	TX
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	11643	TN
3	122300000X	Dentist	100399	CA
4	122300000X	Dentist	11643	TN

General Provider Information

NPI Number	:	1306299037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COREY PAUL YAMASHITA PAULINO DMD

Provider Business Mailing Address
First Line	:	3446 MELVINA DR
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75033-1052
Country	:	US
Telephone Number	:	480-262-5802
Fax Number	:

Provider Business Practice Location Address
First Line	:	3760 W NORTHWEST HWY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75220-4943
Country	:	US
Telephone Number	:	480-262-5802
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	02/27/2026

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