Ky TN Oral Surgery PLLC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

30866 Issued in TN

Legal business name

KY TN ORAL SURGERY PLLC

Practice address

1109 Poplar St
Murray, KY 42071-2360

Phone

(270) 759-4063

Fax

(270) 759-4920

NPI assigned

Jun 13, 2012

Last updated

Jul 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Lee Bobo, DDS, MDNPI 1417031436

Title

Partner/ Member

Phone

(270) 759-4063

Specialties & licenses 8

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Lee Bobo, DDS MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Murray, KY
  • NPI 1417031436
  Authorized official Same address or phone
• James Willis Pledger II, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Peoria, IL
  • NPI 1265599864
  NPD (past)

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341964800000",
    "number": "1093077166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 POPLAR ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712360",
            "telephone_number": "270-759-4063",
            "fax_number": "270-759-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 POPLAR ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712360",
            "telephone_number": "270-759-4063",
            "fax_number": "270-759-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KY TN ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-07-11",
        "status": "A",
        "authorized_official_last_name": "BOBO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PARTNER/ MEMBER",
        "authorized_official_telephone_number": "270-759-4063",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "7465",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "8841",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "7404",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "8334",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KY",
            "license": "34759",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TN",
            "license": "30866",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KY",
            "license": "8841",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TN",
            "license": "8334",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Lane Krantz, BSPHARM
• Jamie Lynn Krause
• Kroger Limited Partnership I (Kroger Pharmacy)
• Janine Kathryn Kruger, MD
• Amanda Elaine Krzyzanowski, LAT, ATC
• Roger D Lampkin Jr., D.P,M.
• Stacey M. Lawson
• Melissa Layton, SLP-CCC
• LBL Urgent Care Physicians
• Legacy Oxygen and Home Care Equipment LLC

• Oral & Maxillofacial Surgery (D.M.D.) in Murray, KY
• Providers in Murray, KY by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.