Individual provider Active NPI

Thomas E Osborne, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Atlanta, GA
National Provider Identifier
1366450371
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
10606 Issued in GA
Practice address
2295 Parklake Dr NE
Suite 240
Atlanta, GA 30345-2844
Phone
(770) 723-9965
Fax
(770) 270-6851
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 10606 GA Primary

Addresses

Primary practice location

2295 Parklake Dr NE
Suite 240
Atlanta, GA 30345-2844

Mailing address

2295 Parklake Dr NE
Suite 240
Atlanta, GA 30345-2844
Phone (770) 723-9965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000683 GA Practitioner - Oral Surgery 3072511229 Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10606GAMDOral & Maxillofacial Surgery (D.M.D.)
010606GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Donald Phillips Oral Surgery PastSince Apr 14, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1366450371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 PARKLAKE DR NE",
            "address_2": "SUITE 240",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452844",
            "telephone_number": "770-723-9965",
            "fax_number": "770-270-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 PARKLAKE DR NE",
            "address_2": "SUITE 240",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452844",
            "telephone_number": "770-723-9965",
            "fax_number": "770-270-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "GA",
            "license": "10606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.