JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY, LLC (NPI# 1720601230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720601230 |
| Entity Type | Organization |
| Organization Name | JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY, LLC |
| Practice Address |
1021 W Oakland Ave Ste 109 Johnson City TN 37604-2192 |
| Practice Telephone | 4232834555 |
| Mailing Telephone | 4232834555 |
| Enumeration Date | 2020-05-19 |
| Last Update Date | 2020-05-19 |
| Authorized Official Name | MATTHEW SHERBAN (PRESIDENT) |
| Authorized Official Telephone | 4232834555 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
1021 W OAKLAND AVE STE 109 |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-2192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699312306 | Bundled Payment Services, LLC | Oral & Maxillofacial Surgery | 3319 W End Ave Ste 700, Nashville, TN 37203-6840 | 2019-12-02 |
| 1952954281 | Farragut Oral Surgery and Implant Center, PC | Oral & Maxillofacial Surgery | 1928 Alcoa Hwy Bldg B, Knoxville, TN 37920-1502 | 2019-07-16 |
| 1821586793 | Nicholas John Ledderhof | Oral & Maxillofacial Surgery | 1930 Alcoa Hwy. Medical Building A, Suite 335, Knoxville, TN 37920-1514 | 2018-04-26 |
| 1497263941 | Cumberland Surgical Arts and Associates, Pllc | Oral & Maxillofacial Surgery | 1275 Parkway Place, Clarksville, TN 37042 | 2018-01-18 |
| 1104202761 | Vanderbilt University Medical Center | Oral & Maxillofacial Surgery | 1301 22nd Ave S, Nashville, TN 37232-5100 | 2015-08-06 |
| 1629398417 | Steven Zambrano | Oral & Maxillofacial Surgery | 7535 Poplar Ave., Germantown, TN 38138 | 2010-06-03 |
| 1538327655 | Oral & Maxillofacial Surgery Assoc PC | Oral & Maxillofacial Surgery | 11213 W Point Dr Ste 501, Knoxville, TN 37934-2838 | 2008-05-27 |
| 1336226448 | J Sidney Boyd | Oral & Maxillofacial Surgery | 610 W Seventh North St, Morristown, TN 37814 | 2006-11-01 |
| 1730133695 | Cumberland Surgical Arts, Pllc | Oral & Maxillofacial Surgery | 2285 Rudolphtown Rd, Suite 200, Clarksville, TN 37043 | 2006-05-22 |
| 1831173392 | J Benjamin Rivers Dmd PC | Oral & Maxillofacial Surgery | 6906 Kingston Pike, Suite 205, Knoxville, TN 37919-5704 | 2005-11-30 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY, 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.