Provider Demographics
NPI:1811935570
Name:SVANE, TODD J (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:J
Last Name:SVANE
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 N FM 1417
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-3424
Mailing Address - Country:US
Mailing Address - Phone:903-868-1370
Mailing Address - Fax:903-893-6028
Practice Address - Street 1:2903 N FM 1417
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-3424
Practice Address - Country:US
Practice Address - Phone:903-868-1370
Practice Address - Fax:903-893-6028
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142531223S0112X, 204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
190009680OtherRR MDCR
TX110909203Medicaid
84D155OtherBCBS
T85081Medicare UPIN
190009680OtherRR MDCR