SAMUEL MCKENNA (NPI# 1376635706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376635706 |
| Entity Type | Individual |
| Full Name | SAMUEL MCKENNA |
| Credential | MD, DDS |
| Practice Address |
719 Thompson Ln Ste 30330 Nashville TN 37204-4701 |
| Mailing Address |
3601 The Vanderbilt Clinic Nashville TN 37232-5100 |
| Practice Telephone | 6153223000 |
| Mailing Telephone | 6153223000 |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2020-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
6909 | TN | Dental Providers |
| Y | 204E00000X | Oral & Maxillofacial Surgery | 15993 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
719 THOMPSON LN STE 30330 |
| City | NASHVILLE |
| State | TN |
| Zip Code | 37204-4701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922048321 | Wendi R. Mason | Nurse Practitioner | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2006-06-07 |
| 1134766975 | Charina J Pelayo | Nurse Anesthetist, Certified Registered | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2019-11-27 |
| 1265085237 | Stacey Moore | Social Worker | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2019-07-18 |
| 1205344009 | Redor Nuri Abdullah | Nurse Practitioner | 719 Thompson Ln Ste 30330, Nashville, TN 37204 | 2018-01-14 |
| 1316454820 | Shelby Sanford Woltjen | Nurse Anesthetist, Certified Registered | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2018-01-05 |
| 1265954911 | Mary Elizabeth Wood | Psychologist | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2017-07-14 |
| 1902255367 | Alexander H De Castro-abeger | Internal Medicine | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2016-06-07 |
| 1639527559 | Sylvia C Hagberg-fitch | Nurse Practitioner | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2016-06-01 |
| 1285019091 | Carlos Alberto Plancarte | Pediatrics | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2015-07-22 |
| 1750761516 | Stuart Abel | Surgery | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2015-06-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992304893 | Results-ast Jv, LLC | Physical Therapist | 2659 8th Avenue South, Nashville, TN 37204 | 2020-10-21 |
| 1811516933 | Kinsley Ojukwu | Student in an Organized Health Care Education/Training Program | Oho Primary Care North, 719 Thompson Ln Suite 20400, Nashville, TN 37204 | 2020-04-09 |
| 1649777350 | Ian Bentley | Student in an Organized Health Care Education/Training Program | 719 Thompson Lane, Pod B, Nashville, TN 37204 | 2018-04-09 |
| 1134622160 | Joshua Shane Carty | Student in an Organized Health Care Education/Training Program | 719 Thompson Ln Pod A, Nashville, TN 37204 | 2018-03-15 |
| 1205340197 | Cam LLC | Chiropractor | 2694 Fessey Ct., Nashville, TN 37204 | 2017-11-30 |
| 1679097141 | Lacey Cross | Nurse Practitioner | 2694 Fessey Court, Nashville, TN 37204 | 2017-07-27 |
| 1346763042 | Lucy Elaine Davidson | Counselor | 416 East Iris Dr., Nashville, TN 37204 | 2017-07-25 |
| 1316468358 | Jasmine Kennedy Jester | Counselor | 717 Hart Lane, Nashville, TN 37204 | 2017-06-29 |
| 1447789649 | Jessica Ramey | Counselor | 4623 Trousdale Drive, Nashville, TN 37204 | 2017-06-09 |
| 1023555893 | Anna Claire Lowder | Marriage & Family Therapist | 701 Bradford Avenue, Nashville, TN 37204 | 2017-01-31 |
| Find all providers in zip 37204 | ||||
| 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 |
| 1104202761 | Vanderbilt University Medical Center | Oral & Maxillofacial Surgery | 1301 22nd Ave S, Nashville, TN 37232-5100 | 2015-08-06 |
| 1699118232 | Erik Jens Nielsen | Oral & Maxillofacial Surgery | 1623 The Vanderbilt Clinic, Vanderbilt University Medical Center, Nashville, TN 37232-0001 | 2013-04-13 |
| 1952356065 | Vanderbilt University | Oral & Maxillofacial Surgery | 3601 The Vanderbilt Clinic, Nashville, TN 37232-5100 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720601230 | Johnson City Oral and Maxillofacial Surgery, LLC | Oral & Maxillofacial Surgery | 1021 W Oakland Ave Ste 109, Johnson City, TN 37604-2192 | 2020-05-19 |
| 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 |
| 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 |
| 1033112180 | Steven P Tipps | Oral & Maxillofacial Surgery | 6015 Shallowford Road, Chattanooga, TN 37421-1688 | 2005-05-23 |
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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.