KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY PSC (NPI# 1457379307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457379307 |
| Entity Type | Organization |
| Organization Name | KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY PSC |
| Practice Address |
4097 Atwood Drive Richmond KY 40475-2454 |
| Practice Telephone | 8596237711 |
| Practice Fax Number | 8596242611 |
| Mailing Telephone | 8596237711 |
| Mailing Fax Number | 8596242611 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2016-02-04 |
| Authorized Official Name | MRS. REDA S VAUGHN (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 8592789376 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100182680 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457847691 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Oral & Maxillofacial Surgery | 2424 Sir Barton Way Ste 375, Lexington, KY 40509-2521 | 2018-07-10 |
| 1679527865 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Dentist | 2533 Larkin Rd, Ste 101, Lexington, KY 40503-3278 | 2006-05-20 |
| 1245882349 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Dentist | 2424 Sir Barton Way Ste 375, Lexington, KY 40509-2747 | 2019-07-10 |
| 1902948987 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Oral & Maxillofacial Surgery | 2533 Larkin Rd, Lexington, KY 40503-3278 | 2007-02-13 |
| 1437177375 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Dentist | 3141 Beaumont Centre Cir, Suite 103, Lexington, KY 40513-1934 | 2006-07-18 |
| 1023036480 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Dentist | 105 Diagnostic Dr, Frankfort, KY 40601-6524 | 2006-07-17 |
| Street Address |
4097 ATWOOD DRIVE |
| City | RICHMOND |
| State | KY |
| Zip Code | 40475-2454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740323633 | Kentucky Center for Oral & Maxillofacial Surgery, Psc | Oral & Maxillofacial Surgery | 4097 Atwood Drive, Richmond, KY 40475-2454 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922611300 | Christina Panter | Social Worker | 370 Highland Drive, Ste 1a, Richmond, KY 40475 | 2020-08-26 |
| 1952875387 | Visionary Therapy Center, LLC | Speech-Language Pathologist | 100 Ky Hwy 15 South, Suite 136, Jackson, KY 40475 | 2019-01-18 |
| 1639656911 | Brian Kettler | Physical Therapy Assistant | 2025 Corporate Dr Ste 2, Richmond, KY 40475 | 2018-07-19 |
| 1376063198 | Erin Danielle Burt | Developmental Therapist | 100 Eastern Hills Drive, Richmond, KY 40475 | 2017-06-22 |
| 1477088730 | Paul Henley Jr. | Student in an Organized Health Care Education/Training Program | 157 Shelby Court, Richmond, KY 40475 | 2017-04-25 |
| 1700310455 | Center for Behavioral Health Kentucky, Inc. | Clinic/Center | 1018 Ival Jame Bvld, Suite C, Richmond, KY 40475 | 2017-04-19 |
| 1790221000 | Darisha Jenkins | Counselor | 435 Gibson Lane, Richmond, KY 40475 | 2017-01-10 |
| 1992259402 | Kendra Gross | Counselor | 451 Big Hill Ave Ste 5, Richmond, KY 40475 | 2016-08-12 |
| 1386095032 | Shantila Nicole Wolford | Case Manager/Care Coordinator | 411 Gibson Lane, Richmond, KY 40475 | 2016-06-23 |
| 1154776540 | Jessica Conley | Social Worker | 105 Masters Court, Richmond, KY 40475 | 2016-05-04 |
| Find all providers in zip 40475 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| 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 |
|---|---|---|---|---|
| 1053971861 | Jennifer Rose Van Hook | Dentist | Vcuhs Dept of Omfs Residency, 980566, 1250 E. Marshall Street, Richmond, VA 23298-0566 | 2019-06-14 |
| 1235628991 | Michael Jonathan Theiss | Dentist | 1250 E Marshall St # 980566, Richmond, VA 23298-5051 | 2018-05-08 |
| 1427460799 | Charles Douglas Boxx | Dentist | 8503 Patterson Ave Ste B, Richmond, VA 23229-6442 | 2014-05-21 |
| 1912929753 | James Ellsworth Hornaday | Dentist | 1004 Oak Dr, Richmond, IN 47374-1916 | 2006-07-24 |
| 1811919467 | Jonathan Eric Carlton | Dentist | 8917 Fargo Road, Suite C, Richmond, VA 23229 | 2006-07-24 |
| 1366492415 | Charles L Cuttino | Dentist | 8503 Patterson Ave, Richmond, VA 23229-6442 | 2006-05-11 |
| 1114988029 | Monroe E Harris Jr. | Dentist | 5224 Monument Ave, Richmond, VA 23226-1405 | 2006-03-30 |
| 1538120431 | William D. Dymon | Dentist | 7702 E Parham Rd Ste 103, Richmond, VA 23294 | 2006-03-30 |
| 1588656128 | John Robert Hall | Dentist | 1004 Oak Drive, Richmond, IN 47374 | 2005-08-19 |
| 1417518069 | Michael Troy Board | Dentist | 1250 E Marshall St, Richmond, VA 23298-5051 | 2019-06-25 |
| Find all providers in RICHMOND | ||||
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| 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.