CLARKSVILLE ORAL AND FACIAL SURGERY, PLLC (NPI# 1073748042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073748042 |
| Entity Type | Organization |
| Organization Name | CLARKSVILLE ORAL AND FACIAL SURGERY, PLLC |
| Other Organization Name | CLARKSVILLE ORAL AND MAXILLOFACIAL SURGERY |
| Practice Address |
1718 Memorial Dr Clarksville TN 37043-4542 |
| Practice Telephone | 9315524935 |
| Practice Fax Number | 9315520959 |
| Mailing Telephone | 9315524935 |
| Mailing Fax Number | 9315520959 |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2016-06-15 |
| Authorized Official Name | JASON SCOTT LILLY (OWNER) |
| Authorized Official Telephone | 9315527575 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4003 | TN | Dental Providers |
| Other Name | Type Code |
|---|---|
| Clarksville Oral and Maxillofacial Surgery | Former Legal Business Name - Organization |
| Street Address |
1718 MEMORIAL DR |
| City | CLARKSVILLE |
| State | TN |
| Zip Code | 37043-4542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861415713 | Ted R Mccurdy | Dentist | 1718 Memorial Dr, Clarksville, TN 37043-4542 | 2006-07-25 |
| 1811502941 | Knowbull Chiropractic | Chiropractor | 1718 Memorial Dr, Clarksville, TN 37043-4542 | 2020-09-15 |
| 1649658295 | Anthony Joseph Linza Jr. | Chiropractor | 1718 Memorial Dr, Clarksville, TN 37043-4542 | 2015-05-15 |
| 1245315621 | Mccurdy & Ellis. Plc | Clinic/Center | 1718 Memorial Dr, Clarksville, TN 37043-4542 | 2006-10-26 |
| 1396759189 | Roger Terry Ellis | Dentist | 1718 Memorial Dr, Clarksville, TN 37043-4542 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952958464 | Barbara Gallahan | Technician | 3992 Lakewood Dr., Clarksville, TN 37043 | 2019-08-20 |
| 1144874728 | Intricate Care | Registered Nurse | 2299 Raleigh Ct, Clarksville, TN 37043 | 2019-07-31 |
| 1740842145 | Caila Anne Wiblitzhouser Holm | Counselor | 755 Weatherly Drive, Clarksville, TN 37043 | 2019-07-05 |
| 1407416407 | Heartland Dental Care of Tennessee, PC | Dentist | 930 Highway 76, Clarksville, TN 37043 | 2019-06-20 |
| 1376021501 | Stephen Lawrence Rego | Case Manager/Care Coordinator | Cohen Military Family Clinic, 775 Weatherly Dr, Clarksville, TN 37043 | 2018-07-31 |
| 1366928095 | Kendra Lee | Social Worker | 775 Weatherly Dr., Clarksville, TN 37043 | 2018-07-16 |
| 1245742931 | Andrea L Edelstein | Dentist | 1818 Memorial Dr., Unit 47, Clarksville, TN 37043 | 2017-11-02 |
| 1043736119 | Megan Pritchett Landre | Behavior Technician | 990 South Ridge Trail, Clarksville, TN 37043 | 2017-08-20 |
| 1932624798 | Sandra Melissa Corral | Behavior Technician | 139e Old Trenton Rd, Suite B, Clarksville, TN 37043 | 2017-08-13 |
| 1700306032 | Sahiti Kandati | Dentist | 1777 Madison Ste Ste 100, Clarksville, TN 37043 | 2017-06-27 |
| Find all providers in zip 37043 | ||||
| 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 |
|---|---|---|---|---|
| 1710436407 | Central Maryland Oral and Facial Surgical Arts of Clarksville, LLC | Dentist | 12431 Clarksville Pike, Route 108, Clarksville, MD 21029 | 2016-09-23 |
| 1033121942 | John C. Gunn | Dentist | 2145 Old Ashland City Rd, Clarksville, TN 37043-4906 | 2006-08-12 |
| 1861415713 | Ted R Mccurdy | Dentist | 1718 Memorial Dr, Clarksville, TN 37043-4542 | 2006-07-25 |
| 1588614804 | George S. Lee | Dentist | 2285 Rudolphtown Road, Suite 200, Clarksville, TN 37043 | 2006-05-10 |
| 1558879007 | Cumberland Surgical Arts and Associates, Pllc | Dentist | 2285 Rudolphtown Road, Suite 200, Clarksville, TN 37043 | 2018-01-18 |
| 1912226895 | Jason Scott Lilly | Dentist | 2285 Rudolphtown Rd, Clarksville, TN 37043 | 2010-05-18 |
| 1609063817 | John C Gunn II Dmd PC | Dentist | 2145 Old Ashland City Rd, Clarksville, TN 37043-4906 | 2007-10-02 |
| 1396759189 | Roger Terry Ellis | Dentist | 1718 Memorial Dr, Clarksville, TN 37043-4542 | 2006-07-28 |
| 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 | ||||
| City | CLARKSVILLE |
| Zip Code | 37043 |
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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.