MEDICARE: COPPELL ORAL AND FACIAL SURGERY, PLLC

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)	32448	TX

General Provider Information

NPI Number	:	1407341191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COPPELL ORAL AND FACIAL SURGERY, PLLC

Provider Business Mailing Address
First Line	:	600 S DENTON TAP RD STE 300
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-4533
Country	:	US
Telephone Number	:	972-366-0065
Fax Number	:	972-744-3305

Provider Business Practice Location Address
First Line	:	600 S DENTON TAP RD STE 300
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-4533
Country	:	US
Telephone Number	:	972-366-0065
Fax Number	:	972-744-3305

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. IGOR N TIKHONOV
Credential	:	DDS, MD
Telephone Number	:	972-366-0065

Provider Enumeration Date	:	06/26/2018
Last Update Date	:	04/03/2026

Similar Medicare Providers

1457618498 — IGOR N TIKHONOV DDS, MD
Practice Location Address:

600 S DENTON TAP RD STE 300
COPPELL, TX
75019-4533

Practice Phone: 206-719-8396
Practice Fax: 972-744-3305

1659578730 — MRS. PAM HARRIS WEBER M.ED.
Practice Location Address:

600 S DENTON TAP RD , SUITE NUMBER 122
COPPELL, TX
75019-4533

Practice Phone: 214-674-0881
Practice Fax:

1679826879 — LISA MARIE MORIN M.A., L.P.C.
Practice Location Address:

600 S DENTON TAP RD
COPPELL, TX
75019-4533

Practice Phone: 469-583-4568
Practice Fax: 972-745-4542

1033463609 — MARY FALLER M.A., L.P.C.
Practice Location Address:

600 S DENTON TAP RD
COPPELL, TX
75019-4533

Practice Phone: 716-983-5322
Practice Fax:

1770975591 — MR. MARK VAN ZANT LPC, NCC
Practice Location Address:

600 S DENTON TAP RD , SUITE 135
COPPELL, TX
75019-4533

Practice Phone: 469-759-9572
Practice Fax:

1326933375 — DR. HANNAH NOELLE BROWN OTD, OTR/L
Practice Location Address:

3100 OLYMPUS BLVD STE 500
COPPELL, TX
75019-5473

Practice Phone: 208-449-7291
Practice Fax:

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