C. Edward Brooks, D.D.S.
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Knoxville, TN
NPI 1336367382 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1336367382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 3145 (TN)
- Practice address
- 11226 W Point Dr
Suite B
Knoxville, TN 37934-2837 - Phone
- (865) 675-5646
- Fax
- (865) 675-5646
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3145 | TN | MD | Surgical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 3145 | TN | Yes |
Addresses
Primary practice location
11226 W Point Dr
Suite B
Knoxville, TN 37934-2837
Mailing address
11226 W Point Dr
Suite B
Knoxville, TN 37934-2837
Phone (865) 675-5646
Other providers in Knoxville, TN
- Broken Vessels Counseling PLLC
- Lauren Adele Brombach
- Mary Louise Brooke
- Melinda Kaye Brookman
- Brandon Brooks
- Casey Ann Brooks
- Claire Addison Brooks
- Crystalin D Brooks
- Deborah Michelle Brooks
- Emily Elizabeth Armstrong Brooks
All providers in Knoxville, TN · Oral and Maxillofacial Surgery (Dentist) in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.