THE REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PC


Address: 1021 W Oakland Ave, Suite 109, Johnson City, TN 37604-2191
Phone: 4232834555

THE REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PC (NPI# 1427163666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427163666
Entity Type Organization
Organization Name THE REGIONAL CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PC
Practice Address 1021 W Oakland Ave
Suite 109
Johnson City
TN 37604-2191
Practice Telephone 4232834555
Practice Fax Number 4232833044
Mailing Telephone 4232834555
Mailing Fax Number 4232833044
Enumeration Date 2006-08-20
Last Update Date 2020-08-22
Authorized Official Name DR. CHARLES EDWARD WITKOWSKI (OWNER)
Authorized Official Telephone 4232834555
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
DS004426 TN Dental Providers

Office Location

Street Address 1021 W OAKLAND AVE
SUITE 109
City JOHNSON CITY
State TN
Zip Code 37604-2191

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639160815 James Richard Risney Dermatology 1021 W Oakland Ave, Suite 102, Johnson City, TN 37604-2191 2005-11-04
1508231572 Appalachian Emergency Physicians Emergency Medicine 1021 W Oakland Ave, Suite 201, Johnson City, TN 37604-2191 2015-12-02
1013314384 Samantha Manuel I Nurse Practitioner 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 2014-12-02
1386902971 Douglas Edema Family Medicine 1021 W Oakland Ave, Suite 207, Johnson City, TN 37604-2191 2012-05-02
1720269731 Nerissa Licup Internal Medicine 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 2007-11-19
1336335835 Ambreen Adil Warsy Family Medicine 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 2007-09-18
1306036041 Mountain States Health Alliance Personal Emergency Response Attendant 1021 W Oakland Ave, Suite 310, Johnson City, TN 37604-2191 2007-07-30
1255341509 Blue Ridge Medical Management Corporation Nursing Facility/Intermediate Care Facility 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 2006-08-09
1124043120 Jeremy Nathan Elliott Family Medicine 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 2006-07-12
1497719322 Brittany M Cantrell Physician Assistant 1021 W Oakland Ave, Suite 301, Johnson City, TN 37604-2191 2006-04-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417560707 Brant Logan Nickens Physical Therapist 809 Lamont St and Veterans Way, Johnson City, TN 37604 2020-08-26
1952911562 David Sandlin Hobbs Pharmacist Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 2020-08-07
1528688272 Whitney Marie Ward Physical Therapist Lamont Street and Veterans Way, Johnson City, TN 37604 2020-04-23
1861050015 Akesh Thomas Student in an Organized Health Care Education/Training Program Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 2019-06-03
1336629021 Medical Education Assistance Corporation Clinic/Center 820 W Market St, Johnson City, TN 37604 2018-08-21
1093208951 Lauren Tiffany Hayden Physician Assistant 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 2018-06-14
1174014450 Jerica Moore Specialist/Technologist 1041 Hamiltion Place Dr., Johnson City, TN 37604 2018-05-23
1053809442 Syed Ghazanfar Hasan Student in an Organized Health Care Education/Training Program Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 2018-05-01
1699262485 Sonia Kumari Oad Student in an Organized Health Care Education/Training Program 178 West Maple St, Johnson City, TN 37604 2018-04-17
1821519364 Mahmoud El Iskandarani Internal Medicine 1084 W Oakland Avenue, 748, Johnson City, TN 37604 2017-07-06
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Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295898286 James Leonard Desantis Dentist 535 Columbia Drive, Johnson City, NY 13790 2006-12-19
1790750586 Sandford W Prince Dentist 2306 Knob Creek Road #108, Knob Creek Oral Clinic, Johnson City, TN 37604 2006-02-23
1104812213 Martin R Pittman Dds Ms PC Dentist 111 W Fairview Ave, Johnson City, TN 37604-5632 2005-09-23
1295736569 Carl W Eilers Jr. Dentist 508 Princeton Rd, Suite 204, Johnson City, TN 37601-2060 2005-08-09
1588634471 Charles Edward Witkowski Sr. Dentist 1021 W Oakland Ave, Suite 109, Johnson City, TN 37604-2191 2006-01-24
1518969229 L Alan Bacon Dds PC & John Collins Dds PC Dentist 508 Princeton Rd, Suite 204, Johnson City, TN 37601-2060 2005-08-12

Providers in the same taxonomy and state

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
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Competitor

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City JOHNSON CITY
Zip Code 37604

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Dataset Information

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.

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