NPIMap

Tri-State Oral and Maxillofacial Surgery LLC

Organization Active NPI Oral and Maxillofacial Surgery Clinic/Center · Hebron, KY

NPI 1003099227 · NPPES record last updated Dec 11, 2007

Key facts

NPI
1003099227
Entity type
Organization (NPI type 2)
Primary specialty
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X
License
803 (KY)
Legal business name
TRI-STATE ORAL AND MAXILLOFACIAL SURGERY LLC
Practice address
2300 Conner Rd
Hebron, KY 41048
Phone
(859) 586-4825
Fax
(859) 586-4817
NPI assigned
Dec 11, 2007
Organization subpart
No

Authorized official

Name
Dr. Rodney Christopher Stigall, DMD NPI 1558574756
Title
Member
Phone
(859) 586-4825

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

2300 Conner Rd
Hebron, KY 41048
Phone (859) 586-4825

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 803 KY Yes

Addresses

Primary practice location

2300 Conner Rd
Hebron, KY 41048

Mailing address

2300 Conner Rd
Hebron, KY 41048
Phone (859) 586-4825

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 11, 2007.

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1003099227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CONNER RD",
            "city": "HEBRON",
            "state": "KY",
            "postal_code": "41048",
            "telephone_number": "859-586-4825",
            "fax_number": "859-586-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CONNER RD",
            "city": "HEBRON",
            "state": "KY",
            "postal_code": "41048",
            "telephone_number": "859-586-4825",
            "fax_number": "859-586-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE ORAL AND MAXILLOFACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "STIGALL",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "859-586-4825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hebron, KY

All providers in Hebron, KY · Oral and Maxillofacial Surgery Clinic/Center in Kentucky

Sources for this page

Verify at the official NPI Registry.