Liberty Oral and Facial Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

LIBERTY ORAL AND FACIAL SURGERY

Practice address

535 Bell Trace CT
Clarksville, TN 37040

Phone

(931) 999-7100

Fax

(931) 999-7101

NPI assigned

May 19, 2021

Last updated

May 19, 2021By 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

Michael J McNaught, DDSNPI 1124222435

Title

Owner

Phone

(931) 999-7100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Justin McNaught, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Clarksville, TN
  • NPI 1124222435
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1548834963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 BELL TRACE CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-999-7100",
            "fax_number": "931-999-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 BELL TRACE CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37040",
            "telephone_number": "931-999-7100",
            "fax_number": "931-999-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY ORAL AND FACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "MCNAUGHT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-999-7100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charity Celeste Lewis
• Jennifer Joan Lewis, RBT
• Joanna Akilah Abad Lewis
• Rita Roberta Lewis
• Carolyn S Liangco
• Alexandria Licht
• Nathan Lidsky, MD
• Life's Counseling, LLC
• Andrew Lightner
• Michael Thomas Ligon

• Oral and Maxillofacial Surgery (Dentist) in Clarksville, TN
• Providers in Clarksville, 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 May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.