PROFESSIONAL MEDICAL PROPERTIES, LLC (NPI# 1700970407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700970407 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL MEDICAL PROPERTIES, LLC |
| Other Organization Name | CENTER FOR ORAL FACIAL AND IMPLANT SURGERY |
| Practice Address |
6015 Shallowford Road Chattanooga TN 37421-1688 |
| Practice Telephone | 4239549180 |
| Practice Fax Number | 4239543054 |
| Mailing Telephone | 4238933333 |
| Mailing Fax Number | 4239543054 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2018-04-04 |
| Authorized Official Name | DR. WAYNE E TIPPS (PRESIDENT/PARTNER) |
| Authorized Official Telephone | 4238933333 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
1224 | TN | Ambulatory Health Care Facilities |
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3287837 | 05 |
| Other Name | Type Code |
|---|---|
| Center for Oral Facial and Implant Surgery | Doing Business As Name - Organization |
| Street Address |
6015 SHALLOWFORD ROAD |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421-1688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112180 | Steven P Tipps | Oral & Maxillofacial Surgery | 6015 Shallowford Road, Chattanooga, TN 37421-1688 | 2005-05-23 |
| 1851474563 | Associates In Oral and Maxillofacial Surgery, P. C. | Oral & Maxillofacial Surgery | 6015 Shallowford Road, Chattanooga, TN 37421-1688 | 2006-10-24 |
| 1154324804 | Wayne E Tipps | Oral & Maxillofacial Surgery | 6015 Shallowford Road, Chattanooga, TN 37421-1688 | 2005-05-25 |
| 1578566519 | John A Spann | Oral & Maxillofacial Surgery | 6015 Shallowford Road, Chattanooga, TN 37421-1688 | 2005-05-23 |
| 1346243383 | Harry E Jones | Oral & Maxillofacial Surgery | 6015 Shallowford Road, Chattanooga, TN 37421-1688 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1750921367 | Stephan Ian Belasco | Counselor | 1360 Mackey Branch Dr., Chattanooga, TN 37421 | 2020-01-11 |
| 1932745817 | Sound Living Inc | Community/Behavioral Health | 6727 Heritage Business Court, Suite 720, Chattanooga, TN 37421 | 2019-11-26 |
| 1245875046 | Chattanooga Compounding Pharmacy Inc. | Pharmacy | 7032 East Brainerd Rd, Suite A-b, Chattanooga, TN 37421 | 2019-11-15 |
| 1083105803 | Trauma and Addiction Recovery Center | Counselor | 6727 Heritage Business Ct Ste 718, Chattanooga, TN 37421 | 2018-05-29 |
| 1497257448 | Claude James Bowden | Counselor | 7372 Applegate Lane, Chattanooga, TN 37421 | 2018-03-06 |
| 1093213332 | Preferred Primary Care | Clinic/Center | 6031 Shallowford Rd Ste 105, Chattanooga, TN 37421 | 2018-01-31 |
| 1124526777 | Elizabeth Marie Wright | Nurse Practitioner | 6130 Shallowford Rd Ste 101, Chattanooga, TN 37421 | 2018-01-30 |
| 1477065712 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 7326 Mccutcheon Rd, Chattanooga, TN 37421 | 2017-10-26 |
| 1144746645 | Mobility At Home LLC | Contractor | 6307 E Brainerd Rd, Chattanooga, TN 37421 | 2017-08-16 |
| Find all providers in zip 37421 | ||||
| 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 |
|---|---|---|---|---|
| 1235769241 | Farragut Dental Studio Pllc | Clinic/Center | 11201 W Point Dr Ste 101, Farragut, TN 37934-2834 | 2020-01-17 |
| 1003250523 | Scott A Weiskopf Dds Inc | Clinic/Center | 8511 Mysen Cv, Cordova, TN 38018-7391 | 2013-04-26 |
| 1770514911 | Stonecrest Oral and Maxillofacial Surgery, Inc. | Clinic/Center | Ste 385, 300 Stonecrest Blvd, Smyrna, TN 37167-6819 | 2006-07-05 |
| 1891298337 | Knoxville Center for Oral & Maxillofacial Surgery, PC | Clinic/Center | 4533 Papermill Road, Oak Ridge, TN 37830 | 2018-03-12 |
| 1497142137 | Knob Creek Oral Clinic | Clinic/Center | 2306 Knob Creek Rd, Suite 108, Johnson City, TN 37604-2366 | 2015-04-21 |
| 1326449067 | David M Owsley Dmd Pllc | Clinic/Center | 33 W 3rd St, Cookeville, TN 38501-2513 | 2014-09-12 |
| 1730407560 | Plateau Oral Surgery, PC | Clinic/Center | 920 S Willow Ave, Cookeville, TN 38501-4150 | 2010-05-04 |
| 1518130210 | West Tennessee Center for Oral and Facial Surgery | Clinic/Center | 544 Roland Ave, Suite 100, Jackson, TN 38301-4379 | 2008-04-02 |
| 1245315621 | Mccurdy & Ellis. Plc | Clinic/Center | 1718 Memorial Dr, Clarksville, TN 37043-4542 | 2006-10-26 |
| City | CHATTANOOGA |
| Zip Code | 37421 |
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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.