KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PSC (NPI# 1740323633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740323633 |
| Entity Type | Organization |
| Organization Name | KENTUCKY CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PSC |
| Practice Address |
4097 Atwood Drive Richmond KY 40475-2454 |
| Practice Telephone | 8596237711 |
| Practice Fax Number | 8596242611 |
| Mailing Telephone | 8596237711 |
| Mailing Fax Number | 8596242611 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2016-05-03 |
| Authorized Official Name | MS. REDA S. VAUGHN (OFFICE MANAGER) |
| Authorized Official Telephone | 8592789376 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100182700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053453043 | Kentucky Center for Oral & Maxillofacial Surgery, Psc | Oral & Maxillofacial Surgery | 3141 Beaumont Centre Cir, Suite 103, Lexington, KY 40513-1934 | 2007-02-13 |
| 1326180316 | Kentucky Center for Oral & Maxillofacial Surgery, Psc | Dentist | 105 Diagnostic Dr, Frankfort, KY 40601-6524 | 2007-02-13 |
| Street Address |
4097 ATWOOD DRIVE |
| City | RICHMOND |
| State | KY |
| Zip Code | 40475-2454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457379307 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Dentist | 4097 Atwood Drive, Richmond, KY 40475-2454 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922611300 | Christina Panter | Social Worker | 370 Highland Drive, Ste 1a, Richmond, KY 40475 | 2020-08-26 |
| 1952875387 | Visionary Therapy Center, LLC | Speech-Language Pathologist | 100 Ky Hwy 15 South, Suite 136, Jackson, KY 40475 | 2019-01-18 |
| 1639656911 | Brian Kettler | Physical Therapy Assistant | 2025 Corporate Dr Ste 2, Richmond, KY 40475 | 2018-07-19 |
| 1376063198 | Erin Danielle Burt | Developmental Therapist | 100 Eastern Hills Drive, Richmond, KY 40475 | 2017-06-22 |
| 1477088730 | Paul Henley Jr. | Student in an Organized Health Care Education/Training Program | 157 Shelby Court, Richmond, KY 40475 | 2017-04-25 |
| 1700310455 | Center for Behavioral Health Kentucky, Inc. | Clinic/Center | 1018 Ival Jame Bvld, Suite C, Richmond, KY 40475 | 2017-04-19 |
| 1790221000 | Darisha Jenkins | Counselor | 435 Gibson Lane, Richmond, KY 40475 | 2017-01-10 |
| 1992259402 | Kendra Gross | Counselor | 451 Big Hill Ave Ste 5, Richmond, KY 40475 | 2016-08-12 |
| 1386095032 | Shantila Nicole Wolford | Case Manager/Care Coordinator | 411 Gibson Lane, Richmond, KY 40475 | 2016-06-23 |
| 1154776540 | Jessica Conley | Social Worker | 105 Masters Court, Richmond, KY 40475 | 2016-05-04 |
| Find all providers in zip 40475 | ||||
| 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 |
|---|---|---|---|---|
| 1205450319 | Kipley Powell | Oral & Maxillofacial Surgery | Vcuhs Dept of Oral&maxillofacial Residency, 980566, 1250 E. Marshall Street, Richmond, VA 23298-0566 | 2020-06-04 |
| 1831624618 | Christopher Loschiavo | Oral & Maxillofacial Surgery | 1250 E Marshall St, Box 980566, Richmond, VA 23298-5051 | 2017-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457847691 | Kentucky Center for Oral & Maxillofacial Surgery Psc | Oral & Maxillofacial Surgery | 2424 Sir Barton Way Ste 375, Lexington, KY 40509-2521 | 2018-07-10 |
| 1750552733 | Romeo N. Laureano, D.m.d., P.s.c. | Oral & Maxillofacial Surgery | 120 W Stephen Foster Ave Ste 107, Bardstown, KY 40004-1457 | 2008-03-18 |
| 1831225465 | Jackson Ent Clinic, Psc | Oral & Maxillofacial Surgery | 1550 Highway 15 S Ste 29, Jackson, KY 41339-9221 | 2007-02-26 |
| 1295861524 | William R Anderson Dmd Psc | Oral & Maxillofacial Surgery | 972 Broadway Plaza, Paintsville, KY 41240 | 2007-02-23 |
| 1427145366 | C Michael Brinker | Oral & Maxillofacial Surgery | 8172 Mall Road, Suite 214, Florence, KY 41042 | 2006-10-10 |
| 1629081385 | Tariq A Sartawi | Oral & Maxillofacial Surgery | 1550 Hwy 15 South, Suite #29, Jackson, KY 41339-0768 | 2006-08-14 |
| 1801892047 | David L Wells II | Oral & Maxillofacial Surgery | 2250 Leestown Rd, Veterans Affairs Medical Center-ld Dept of Admin Med, Lexington, KY 40511 | 2005-06-22 |
| 1922480250 | Commonwealth Oral and Maxillofacial Surgery, Psc | Oral & Maxillofacial Surgery | 6520 Glenridge Park Pl, Suite 7, Louisville, KY 40222-3455 | 2015-06-23 |
| 1285942649 | Erena & Peterson, Pllc | Oral & Maxillofacial Surgery | 620 Perimeter Dr, Suite 100, Lexington, KY 40517-4125 | 2010-09-20 |
| 1760706675 | Edyee M Sturgill, Dmd, Md | Oral & Maxillofacial Surgery | 895 Wilkinson Trce Ste B, Bowling Green, KY 42103-2486 | 2010-03-22 |
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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.