Charles H. Shanks, D.D.S., P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS7825 Issued in TN

Legal business name

CHARLES H. SHANKS, D.D.S., P.C.

Practice address

1511 E Lamar Alexander Pkwy
Maryville, TN 37804-5131

Phone

(865) 977-8048

Fax

(865) 977-0318

NPI assigned

Jul 20, 2012

Organization subpart

No

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

Authorized official

Name

Charles Hartwell Shanks, D.D.S.NPI 1558359695

Title

Owner/Oral Surgeon

Phone

(865) 977-8048

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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.

• Charles Hartwell Shanks, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Maryville, TN
  • NPI 1558359695
  Authorized official Same address or phone

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1114272580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045131",
            "telephone_number": "865-977-8048",
            "fax_number": "865-977-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045131",
            "telephone_number": "865-977-8048",
            "fax_number": "865-977-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES H. SHANKS, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "SHANKS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HARTWELL",
        "authorized_official_title_or_position": "OWNER/ORAL SURGEON",
        "authorized_official_telephone_number": "865-977-8048",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS7825",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS7825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1114272580",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORAL SURGERY TAXONOMY NUMBER",
            "identifier": "1223S0112X",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Andreana Chandler, M.S. CCC-SLP
• Jeffrey Garland Chandler, MS, PT
• Data Chapman
• Nelson Hall Chapman, PHARMD
• Charles H. Shanks, D.D.S., P.C.
• Denise Liyana Charlton, M.D.
• Sharon N Chastain, MD
• Jon L Cheek, M.D.
• Samuel Burch Cheek Jr., M.D., M.P.H.
• Irina Chelnokova, MD

• Oral and Maxillofacial Surgery (Dentist) in Maryville, TN
• Providers in Maryville, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.