Andrew Jackson Mills IV, DMD, MD
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Old Hickory, TN
NPI 1508399296 · NPPES record last updated Mar 17, 2025
Key facts
- NPI
- 1508399296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- DS0000010653 (TN)
- Practice address
- 616 Brandywine Village CT
Old Hickory, TN 37138 - Phone
- (615) 883-0067
- Fax
- (615) 883-0365
- NPI assigned
- Apr 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170728002631 | TN | Order and Referring Only - Oral Surgery |
6709157415 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS0000010653 | TN | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cookeville Oral Surgery, PLLC | Oral and Maxillofacial Surgery | Current | Accepting new patients |
| Hermitage Oral Surgery | Oral and Maxillofacial Surgery | Current |
Accepting new patients |
Locations
5651 Frist Blvd
Ste 301
Hermitage, TN 37076
Phone (615) 883-0067
616 Brandywine Village Ct
Old Hickory, TN 37138
Phone (615) 883-0067
Interoperability endpoints
- amills29178@direct.vumc.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) |
1223S0112X | DS0000010653 | TN | Yes |
Addresses
Primary practice location
616 Brandywine Village CT
Old Hickory, TN 37138
Mailing address
616 Brandywine Village CT
Old Hickory, TN 37138
Phone (615) 883-0067
Other providers in Old Hickory, TN
- Matter Health of Tennessee, PLLC
- Jill Jackson McCarthy
- Robert W McDowell
- Michael a. Atchley, DDS P.C.
- Middle Tennessee Homes
- Lauren Bernice Moss
- Phillip C Moss
- Heather L Munoz
- Sharonda Muse
- Nashville Medical Investors LLC
All providers in Old Hickory, 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 Mar 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.