SOUTHEAST ORAL SURGERY PC (NPI# 1154596286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154596286 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ORAL SURGERY PC |
| Practice Address |
11548 Chapman Hwy Seymour TN 37865 |
| Practice Telephone | 8655777800 |
| Mailing Telephone | 8655777800 |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2009-04-15 |
| Authorized Official Name | MICHELLE L TRACY (OFFICE MANAGER) |
| Authorized Official Telephone | 8659777110 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881992279 | Southeast Oral Surgery PC | Dentist | 130 Mabry Hood Rd, Suite 105, Knoxville, TN 37922-2221 | 2011-03-09 |
| 1952547366 | Southeast Oral Surgery PC | Dentist | 801 W Oldham Ave, Knoxville, TN 37921-2747 | 2009-01-07 |
| 1184733446 | Southeast Oral Surgery PC | Dentist | 1858 Crest Rd, Maryville, TN 37804-4305 | 2006-08-30 |
| Street Address |
11548 CHAPMAN HWY |
| City | SEYMOUR |
| State | TN |
| Zip Code | 37865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790285492 | Southeast Behavioral Services | Behavioral Analyst | 10721 Chapman Hwy Ste 22, Seymour, TN 37865 | 2018-02-19 |
| 1932645884 | Emma Love Gilmartin | Physician Assistant | 11606 Chapman Hwy Ste 2, Seymour, TN 37865 | 2017-01-17 |
| 1295065209 | Angela Kay Phifer | Acupuncturist | 10339 Chapman Hwy, Unit 2, Seymour, TN 37865 | 2010-01-14 |
| 1639358278 | Marta Finnegan | Case Manager/Care Coordinator | 1016 I.c. King Rd, Seymour, TN 37865 | 2007-10-31 |
| 1053590695 | Mary D Headrick | Registered Nurse | 1016 I. C. King Rd, Brookhaven Retreat, Seymour, TN 37865 | 2007-10-31 |
| 1225217706 | Melissa L Blaque | Case Manager/Care Coordinator | 1016 I.c. King Rd., Brookhaven Retreat, Seymour, TN 37865 | 2007-10-31 |
| 1841479318 | Ilene L Graham | Licensed Practical Nurse | 1061 I.c. King Rd., Brookhaven Retreat, Seymour, TN 37865 | 2007-10-31 |
| 1851597272 | Bethany Ann Thomas | Dentist | 119 Maryville Highway, Suite B, Seymour, TN 37865 | 2007-06-22 |
| 1881800175 | Eric D Lee | Pharmacist | 1125 Creekside Village Way, Seymour, TN 37865 | 2007-05-15 |
| 1679799803 | Walter Edward Geldrich | Nurse Anesthetist, Certified Registered | 1545 Fawn Dr, Seymour, TN 37865 | 2007-04-17 |
| Find all providers in zip 37865 | ||||
| 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 |
|---|---|---|---|---|
| 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.