NPIMap

Organization Active NPI

Chattanooga Oral & Maxillofacial Surgery, PLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Chattanooga, TN
National Provider Identifier
1124295480
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7277 Issued in TN
Legal business name
CHATTANOOGA ORAL & MAXILLOFACIAL SURGERY, PLC
Practice address
1720 Gunbarrel Rd
Suite 200
Chattanooga, TN 37421-3192
Phone
(423) 296-8905
Fax
(423) 296-8906
NPI assigned
May 14, 2008
Last updated
May 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Dr. David P McDonald, DMDNPI 1689663692
Title
Preident/Oral Surgeon
Phone
(423) 296-8905

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 7277 TN Primary

Addresses

Primary practice location

1720 Gunbarrel Rd
Suite 200
Chattanooga, TN 37421-3192

Mailing address

1720 Gunbarrel Rd
Suite 200
Chattanooga, TN 37421-3192
Phone (423) 296-8905

National Provider Directory

National Provider Directory

Locations

1720 Gunbarrel Rd
Ste 200
Chattanooga, TN 37421
Phone (423) 296-8905

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1124295480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 GUNBARREL RD",
            "address_2": "SUITE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213192",
            "telephone_number": "423-296-8905",
            "fax_number": "423-296-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 GUNBARREL RD",
            "address_2": "SUITE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374213192",
            "telephone_number": "423-296-8905",
            "fax_number": "423-296-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATTANOOGA ORAL & MAXILLOFACIAL SURGERY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PREIDENT/ORAL SURGEON",
        "authorized_official_telephone_number": "423-296-8905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "7277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.