Southern Kentucky Oral Surgery Associates PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SOUTHERN KENTUCKY ORAL SURGERY ASSOCIATES PLLC

Practice address

1802 Rockingham Ave
Bowling Green, KY 42104-3348

Phone

(270) 783-0064

NPI assigned

Sep 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vickie Alvey

Title

Credentialing Coordinator

Phone

(270) 783-0064

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1013104892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 ROCKINGHAM AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 ROCKINGHAM AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043348",
            "telephone_number": "270-783-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN KENTUCKY ORAL SURGERY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "ALVEY",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "270-783-0064"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100049450",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100049460",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Kentucky Audiology
• Southern Kentucky Heart Institute,PSC
• Southern Kentucky Medicine Associates, LLC
• Southern Kentucky Mobile Medical Services
• Southern Kentucky Nephrology Associates PSC
• Southern Kentucky Speech Therapy
• Southern Kentucky Surgical, PLLC
• Southern Kentucky Surgicenter, LLC
• Southern Kentucky Urology LLC
• Southern Ky Nephrology

• Oral and Maxillofacial Surgery (Dentist) in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.