Pickett Oral Surgery PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

PICKETT ORAL SURGERY PC

Practice address

248 N Peters Rd Ste 1
Knoxville, TN 37923-4925

Phone

(865) 691-0918

Fax

(865) 691-6215

NPI assigned

Mar 23, 2012

Organization subpart

No

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

Authorized official

Name

David Owen Pickett, DMDNPI 1164664140

Title

President

Phone

(865) 691-0918

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

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

• David O Pickett, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Knoxville, TN
  • NPI 1164664140
  Medicare reassignment Care Compare group NPD Authorized official
• Chet Thomas Matsuura, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Knoxville, TN
  • NPI 1841827177
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1275809394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 N PETERS RD STE 1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234925",
            "telephone_number": "865-691-0918",
            "fax_number": "865-691-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 N PETERS RD STE 1",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234925",
            "telephone_number": "865-691-0918",
            "fax_number": "865-691-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICKETT ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-23",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "PICKETT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "OWEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-691-0918",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Jo Pickel, FNP-BC, AOCNP
• Ryan Baird Pickens, MD
• Pickering & Allen Orthodontics
• Catherine Borgeson Pickering, O.D.
• James Thomas Pickering, DDS
• Bruce E Pickett, COTA/ L
• David O Pickett, DMD
• James Pickett
• Joshua Logan Pickett
• Lisa L Pickett, LPN

• Oral and Maxillofacial Surgery (Dentist) in Knoxville, TN
• Providers in Knoxville, 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 Aug 25, 2023; 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.