The Center for Oral and Maxillofacial Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12546 Issued in MO

Legal business name

THE CENTER FOR ORAL AND MAXILLOFACIAL SURGERY LLC

Practice address

936 Ida St
Poplar Bluff, MO 63901-4210

Phone

(573) 785-8471

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Sheets

Title

Oral Surgeon

Phone

(573) 785-8471

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386763936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 IDA ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 IDA ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014210",
            "telephone_number": "573-785-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR ORAL AND MAXILLOFACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEETS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ORAL SURGEON",
        "authorized_official_telephone_number": "573-785-8471"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "12546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• May Tenchavez
• Cheryl Lynne Terrell, PHD, LPC
• Madison F Terry
• TH Contracting Services of Missouri
• Dana Tharp
• The Other Side Home Health Equipment and Supply
• Maxine A Theriot, MD
• Alyssa Michelle Thompson
• Cassey Thompson
• David Thomas Thompson

• Oral and Maxillofacial Surgery (Dentist) in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.