EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY, PC (NPI# 1770893778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770893778 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE ORAL & MAXILLOFACIAL SURGERY, PC |
| Practice Address |
307 Maple St Athens TN 37303-2957 |
| Mailing Address |
1505 E Lamar Alexander Pkwy Maryville TN 37804-5131 |
| Practice Telephone | 4237458708 |
| Practice Fax Number | 4237464562 |
| Mailing Telephone | 8659838630 |
| Mailing Fax Number | 8659814914 |
| Enumeration Date | 2010-10-12 |
| Last Update Date | 2010-11-18 |
| Authorized Official Name | DR. MARK M WIDLOSKI (OWNER) |
| Authorized Official Telephone | 8659838630 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4711 | TN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306156302 | East Tennessee Oral & Maxillofacial Surgery, PC | Dentist | 700 S Illinois Ave, Bldg A, Suite 104, Oak Ridge, TN 37830-7900 | 2010-10-12 |
| 1043520042 | East Tennessee Oral & Maxillofacial Surgery, PC | Dentist | 1112 Medical Park Ct, Sevierville, TN 37862-6933 | 2010-10-12 |
| 1225348220 | East Tennessee Oral & Maxillofacial Surgery, PC | Dentist | 2939 Essary Rd, Suite 1, Knoxville, TN 37918-2464 | 2010-10-12 |
| 1497065494 | East Tennessee Oral & Maxillofacial Surgery, PC | Dentist | 2253 Chambliss Ave Nw, Suite 403, Cleveland, TN 37311-3861 | 2010-10-12 |
| 1033429030 | East Tennessee Oral & Maxillofacial Surgery, PC | Dentist | 703 K St, Greeneville, TN 37745-6246 | 2010-10-12 |
| 1942510946 | East Tennessee Oral & Maxillofacial Surgery, PC | Dentist | 1551 E Morris Blvd, Morristown, TN 37813-5729 | 2010-10-12 |
| 1174624498 | East Tennessee Oral & Maxillofacial Surgery, PC | Dentist | 1505 E Lamar Alexander Pkwy, Maryville, TN 37804-5131 | 2006-09-26 |
| Street Address |
307 MAPLE ST |
| City | ATHENS |
| State | TN |
| Zip Code | 37303-2957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285242529 | Kelley Anne Seekins | Specialist/Technologist | 204 E. College St., Athens, TN 37303 | 2020-07-22 |
| 1699237511 | Athens Family Dental | Clinic/Center | 746 Tell Street, Athens, TN 37303 | 2019-04-01 |
| 1881185916 | Agnes Ebedi | Counselor | 744 Tell St Ste 100, Athens, TN 37303 | 2018-05-24 |
| 1679002059 | Ashley Y Davis | Nurse Practitioner | 909 Congress Pkwy N, Athens, TN 37303 | 2017-06-08 |
| 1417312521 | Wanda J Dennis | Case Manager/Care Coordinator | 708 Virginia Avenue, Athens, TN 37303 | 2015-12-17 |
| 1376975276 | Jeffrey Allen Hanson | Occupational Therapy Assistant | 1204 Frye Street, Athens, TN 37303 | 2013-08-01 |
| 1043596794 | Jennifer Donahoo | Pharmacist | 1302 Congress Parkway S., Athens, TN 37303 | 2011-10-26 |
| 1093009938 | Leah Calla | Registered Nurse | 393 County Rd 554, Athens, TN 37303 | 2011-06-08 |
| 1407038201 | Carl Quinn Osborn | Orthopaedic Surgery | 627 Congress Parkway South, Athens, TN 37303 | 2007-12-04 |
| 1972791903 | Angela Colleen Stokes | Nurse Practitioner | 1805 Ingleside Dr, Athens, TN 37303 | 2007-10-03 |
| Find all providers in zip 37303 | ||||
| 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 |
|---|---|---|---|---|
| 1962631929 | Nicholas Adam Medel | Dentist | 307 E Clinton Ave, Athens, TX 75751-3405 | 2009-07-10 |
| 1538535331 | Nicholas A Medel Dds PC | Dentist | 307 E Clinton Ave, Athens, TX 75751-3405 | 2015-08-15 |
| 1912277765 | Athens Oral & Maxillo Facial Surgery, PC | Dentist | 2000 Prince Ave, Athens, GA 30606-6022 | 2012-01-11 |
| 1427296094 | James J. Mcdonald Jr. | Dentist | 1010 Prince Ave, Suite 103 South, Athens, GA 30606-5805 | 2009-02-04 |
| 1215198221 | Mcdonald and Manus LLP | Dentist | 1010 Prince Ave, Suite 103 South, Athens, GA 30606-5805 | 2008-06-23 |
| 1922208248 | Jonathan Tomlinson | Dentist | 600 Oglethorpe Ave, Suite 4, Athens, GA 30606-2263 | 2007-07-24 |
| 1083775795 | Timothy Vincent Monroe | Dentist | 410 E State St, Athens, OH 45701-1819 | 2006-12-13 |
| 1386733954 | Stanley D. Satterfield | Dentist | 2000 Prince Ave, Athens, GA 30606-6022 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396199055 | Daniel Coke | Dentist | 1301 Medical Center Dr # 1601, Nashville, TN 37232-0028 | 2016-04-19 |
| 1467835140 | Amir Victor Francis | Dentist | 1100 Poplar View Ln N Ste 1, Collierville, TN 38017-9323 | 2015-06-30 |
| 1376939645 | Matthew Breit | Dentist | 1251 Wesley Dr Ste 101, Memphis, TN 38116-6442 | 2015-04-13 |
| 1720472855 | Charles Baker Felts Iv | Dentist | 901 Riverfront Pkwy Ste 202, Chattanooga, TN 37402-2193 | 2015-03-26 |
| 1073910725 | Nashville Oral Facial Surgery, Pllc | Dentist | 2400 Patterson St Ste 316, Nashville, TN 37203-6510 | 2014-11-24 |
| 1194122135 | Samuel Edward Molind | Dentist | 210 Memorial Dr, Bristol, TN 37620-1704 | 2014-11-19 |
| 1780094052 | Andrew Ferraro | Dentist | 2964 Miller Place Way, Knoxville, TN 37924-1673 | 2014-05-07 |
| 1144649393 | Thomas Bailey | Dentist | 3000 Stansberry Ln Ste 101, Franklin, TN 37069-5125 | 2014-04-15 |
| 1376962613 | John Christopher Swearingen | Dentist | 780 Ridge Lake Blvd Ste 101, Memphis, TN 38120 | 2014-04-15 |
| 1427471382 | Oral & Maxillofacial Surgery Clinic Inc. | Dentist | 910 Madison Ave Ste 710, Memphis, TN 38103-3453 | 2014-01-29 |
| Find all providers with the same taxonomy | ||||
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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.