Organization Active NPI

Regional Oral Surgery Center PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Cookeville, TN
National Provider Identifier
1235213869
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
REGIONAL ORAL SURGERY CENTER PC
Practice address
33 W 3Rd St
Cookeville, TN 38501-2513
Phone
(931) 528-6252
Fax
(931) 372-8526
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Authorized official

Name
Dr. Robert Edwin Brooksbank, D.D.S.
Title
President
Phone
(931) 528-6252

Specialties & licenses 1

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

Addresses

Primary practice location

33 W 3Rd St
Cookeville, TN 38501-2513

Mailing address

33 W 3Rd St
Cookeville, TN 38501-2513
Phone (931) 528-6252

Other identifiers 1

IdentifierTypeStateIssuer
3226337MedicaidTN

National Provider Directory

National Provider Directory

Locations

33 W 3rd St
Cookeville, TN 38501
Phone (931) 528-6252

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1235213869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 W 3RD ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012513",
            "telephone_number": "931-528-6252",
            "fax_number": "931-372-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W 3RD ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012513",
            "telephone_number": "931-528-6252",
            "fax_number": "931-372-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL ORAL SURGERY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "BROOKSBANK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-528-6252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "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": "3226337",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; 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.