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JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY LLC NPI 1720601230


NPI Information

NPI: 1720601230
Provider Name: JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY, LLC
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Organization
Address:
1021 W OAKLAND AVE STE 109
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 283-4555
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JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY, LLC is an oral maxillofacial surgery in Johnson City, TN. The provider is 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. JOHNSON CITY ORAL AND MAXILLOFACIAL SURGERY, LLC NPI is 1720601230. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1021 W OAKLAND AVE STE 109
JOHNSON CITY, TN
ZIP 37604-192
Phone: (423) 283-4555

The provider's authorized official is Matthew Sherban .
The authorized official title is President and has the following contact phone number (423) 283-4555.

The enumeration date for this NPI number is 5/19/2020 and was last updated on 5/19/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1204E00000XOral & Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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