Ccofs Oral Surgery I, LLC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

CCOFS ORAL SURGERY I, LLC

Doing business as

Carolinas Center for Oral & Facial Surgery

Practice address

280 Rocky Slope Rd
Greenville, SC 29607-3908

Phone

(864) 751-9972

NPI assigned

Jul 9, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Rayle Hock

Title

Rco Manager

Phone

(704) 295-4653

Specialties & licenses 1

Addresses

Other names 1

• Carolinas Center for Oral & Facial Surgery Doing business as

Locations

Practitioners 2

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

• Ashley Cannon Tankersley, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenville, SC
  • NPI 1851730634
  NPD (past)
• Brannon Myrick

  • Oral and Maxillofacial Surgery (Dentist)
  • Jackson, MS
  • NPI 1700230083
  NPD (past)

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1396397501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8738 UNIVERSITY CITY BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282133558",
            "telephone_number": "704-295-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 ROCKY SLOPE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073908",
            "telephone_number": "864-751-9972"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Worley Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296093753",
            "country_code": "US",
            "telephone_number": "864-751-9972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CCOFS ORAL SURGERY I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "HOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "RAYLE",
        "authorized_official_title_or_position": "RCO MANAGER",
        "authorized_official_telephone_number": "704-295-4653",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas Center for Oral & Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mindy Lee Cavendish, M.S., CCC-SLP
• Nelson Johan Caviedes, CRNA
• Cbedrugs, LLC
• CCLC Obs LLC
• Ccofs Oral Surgery 2 LLC
• Adrick Dorell Ceasar, PT
• John E. Cebe, M.D.
• Lindsey Caston Cecil, MD
• Ashlie Pruett Ceips, CRNA
• Rebecca Centeno

• Oral & Maxillofacial Surgery (D.M.D.) in Greenville, SC
• Providers in Greenville, SC by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.