James Bradford Lewallen, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8975 Issued in TN

Practice address

3000 Stansberry LN
Suite 101
Franklin, TN 37069-5125

Phone

(615) 591-0919

Fax

(615) 599-6762

NPI assigned

Apr 10, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 12, 2018 through Jul 12, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Southern Oral and Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Franklin, TN
  • NPI 1679671986
  NPD (past)

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1477796100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 STANSBERRY LN",
            "address_2": "SUITE 101",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370695125",
            "telephone_number": "615-591-0919",
            "fax_number": "615-599-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 STANSBERRY LN",
            "address_2": "SUITE 101",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370695125",
            "telephone_number": "615-591-0919",
            "fax_number": "615-599-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWALLEN",
        "first_name": "JAMES",
        "middle_name": "BRADFORD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-10",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "8975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Leslie
• Anna Lester
• Rhonda R Lester, LDN
• McKenzie Roberts Lete, PA-C
• Heather Leusink, CEP, CCRP
• Colleen Minnette Lewellyan, PHARMD
• John H Lewis Jr., PMHNP-BC
• Mary Melissa Lewis, MMFT
• Terri Leigh Lewis, RN
• Lindsey Lictus

• Oral and Maxillofacial Surgery (Dentist) in Franklin, TN
• Providers in Franklin, 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 Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.