SMYRNA ORAL AND MAXILLOFACIAL SURGERY AND IMPLANTOLOGY CENTER, LLC (NPI# 1396064986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396064986 |
| Entity Type | Organization |
| Organization Name | SMYRNA ORAL AND MAXILLOFACIAL SURGERY AND IMPLANTOLOGY CENTER, LLC |
| Other Organization Name | SYMRNA OMS |
| Practice Address |
4849 S Cobb Dr Se Unit 200 Smyrna GA 30080-7145 |
| Mailing Address |
250 Park Avenue West Nw Unit 204 Atlanta GA 30313-1603 |
| Practice Telephone | 6152071932 |
| Mailing Telephone | 6152071932 |
| Enumeration Date | 2010-05-23 |
| Last Update Date | 2010-05-23 |
| Authorized Official Name | DR. CECIL PHILLIP STANCIL JR. (CEO) |
| Authorized Official Telephone | 6152071932 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
DN013667 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Symrna OMS | Doing Business As Name - Organization |
| Street Address |
4849 S COBB DR SE UNIT 200 |
| City | SMYRNA |
| State | GA |
| Zip Code | 30080-7145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104943562 | Kristin Kara Cooney | Dentist | 4849 S Cobb Dr Se, Smyrna, GA 30080-7145 | 2007-03-23 |
| 1740838051 | Todd Graybael Scott | Physical Therapist | 4849 S Cobb Dr Se, Smyrna, GA 30080-7117 | 2019-08-29 |
| 1013574946 | Megan Reich Rihan | Dentist | 4849 S Cobb Dr Se, Smyrna, GA 30080-7117 | 2019-05-27 |
| 1649661307 | Lauren Hughes | Dentist | 4849 S Cobb Dr Se, Smyrna, GA 30080-7145 | 2015-02-16 |
| 1710381165 | Carlos R Johnson | Physical Therapist | 4849 S Cobb Dr Se, Suite 121, Smyrna, GA 30080-7145 | 2014-10-14 |
| 1922400704 | Zachary E Walston | Physical Therapist | 4849 S Cobb Dr Se, Suite 121, Smyrna, GA 30080-7145 | 2014-09-23 |
| 1548662588 | Pt Solutions of Acworth, LLC | Physical Therapist | 4849 S Cobb Dr Se, Suite 121, Smyrna, GA 30080-7145 | 2014-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205169 | Suny Varughese | Nurse Practitioner | Minute Clinic, 2994 Atlanta Rd, Se, Smyrna, GA 30080 | 2020-08-11 |
| 1891287645 | Provident Group - Creekside Properties LLC | Alzheimer Center (Dementia Center) | 4838 South Cobb Drive, Smyrna, GA 30080 | 2018-06-06 |
| 1710490743 | Alina Rim | Registered Nurse | 4532 Chelton Ct Se, Smyrna, GA 30080 | 2017-11-13 |
| 1932626488 | Richard Kyle Davis | Pharmacist | 2955 Atlanta Rd Se, Smyrna, GA 30080 | 2017-08-25 |
| 1982071163 | Amelia Rafaela Turrubiates-huacuja | Counselor | 1246-c Concord Rd, Suite 101, Smyrna, GA 30080 | 2015-08-24 |
| 1275919755 | Anne Waldner Rohling | Physical Therapist | 1155 Concord Rd Se Ste 210, Smyrna, GA 30080 | 2015-08-06 |
| 1790167856 | Kay Yetunde Johnson | Nurse Practitioner | 3001 Lusk Dr, Smyrna, GA 30080 | 2015-06-25 |
| 1689055436 | Anew You Couneling, LLC | Community/Behavioral Health | 3188 Atlanta Rd, Smyrna, GA 30080 | 2015-06-17 |
| 1457766370 | Trondi Jerry | Counselor | 3381 Atlanta Rd Se, Smyrna, GA 30080 | 2014-06-30 |
| 1093081903 | Ashish Kapila | Podiatrist | Wellstar Podiatry, 4441 Atlanta Rd Se Suite 215, Smyrna, GA 30080 | 2012-03-25 |
| Find all providers in zip 30080 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770514911 | Stonecrest Oral and Maxillofacial Surgery, Inc. | Clinic/Center | Ste 385, 300 Stonecrest Blvd, Smyrna, TN 37167-6819 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134682859 | North Atlanta Oral and Maxillofacial Surgery | Clinic/Center | 2555 Westside Pkwy Ste 350, Alpharetta, GA 30004-4191 | 2019-04-09 |
| 1659789170 | Blue Ocean Oral & Maxillofacial Surgery | Clinic/Center | 260 Rucker Rd, Suite 400, Alpharetta, GA 30004-4198 | 2014-07-28 |
| 1164449898 | Jeffrey R. Prinsell, Dmd, Md, P.C. | Clinic/Center | 1950 Spectrum Cir Se Ste B300, Marietta, GA 30067-1657 | 2006-07-17 |
| 1356983746 | Cornerstone Oral and Maxillofacial Surgery | Clinic/Center | 403 Cowart Ave, Valdosta, GA 31602-2635 | 2019-10-17 |
| 1962936302 | Robert S. Attia, Dmd, LLC | Clinic/Center | 1150 Grimes Bridge Rd, Suite 200, Roswell, GA 30075-3988 | 2017-04-12 |
| 1023327822 | North Georgia Oral Surgery, P.C. | Clinic/Center | 6304 Old Highway 5, Suite 102, Woodstock, GA 30188-2443 | 2010-09-28 |
| 1285887497 | Robert J. Kakos Dds PC | Clinic/Center | 1150 Grimes Bridge Rd, Ste. 200, Roswell, GA 30075-3988 | 2008-10-31 |
| 1063682680 | Vidalia Oral and Maxillofacial Surgery, P.C. | Clinic/Center | 310 Maple Dr, Vidalia, GA 30474-8909 | 2008-03-11 |
| 1568661510 | Emory Medical Group, LLC | Clinic/Center | 1365b Clifton Rd Ne, Atlanta, GA 30322-1013 | 2007-07-11 |
| 1790899490 | John J. Beninato, D.d.s., P.C. | Clinic/Center | 21 John Maddox Dr Nw, Suite B, Rome, GA 30165-1413 | 2006-08-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SMYRNA ORAL AND MAXILLOFACIAL SURGERY AND IMPLANTOLOGY CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.