# FACIAL AND COSMETIC SURGERY OF FORT WORTH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Sonneveld Oral & Facial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720690100
- **Authorized official:** KEITH ANDREW SONNEVELD DDS (SINGLE MEMBER/OWNER)
- **Authorized official phone:** (817) 927-1818

## Contact information

- **Practice address:** 5825 EDWARDS RANCH RD STE 200, FORT WORTH, TX 76109-4142
- **Practice address phone:** (817) 927-1818
- **Practice address fax:** (817) 927-2351
- **Mailing address:** 5825 EDWARDS RANCH RD STE 200, FORT WORTH, TX 76109-4142
- **Mailing address phone:** (817) 927-1818
- **Mailing address fax:** (817) 927-2351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/18/2020
- **Last updated:** 08/29/2025