NPIMap

Organization Active NPI

Southern Oral and Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Franklin, TN
National Provider Identifier
1679671986
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
8111 Issued in TN
Legal business name
SOUTHERN ORAL AND FACIAL SURGERY
Practice address
3000 Stansberry Lane
Suite 101
Franklin, TN 37069
Phone
(615) 591-0919
Fax
(615) 599-6762
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Authorized official

Name
Dr. Howard Daniel Clark, DDS, MD
Title
Managing Partner
Phone
(615) 591-0919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 8111 TN Primary

Addresses

Primary practice location

3000 Stansberry Lane
Suite 101
Franklin, TN 37069

Mailing address

3000 Stansberry Lane
Suite 101
Franklin, TN 37069
Phone (615) 591-0919

Other names 1

  • Clark Oral and Facial Surgery Former legal business name

National Provider Directory

National Provider Directory

Locations

761 Old Hickory Blvd
Ste 205
Brentwood, TN 37027

3000 Stansberry Ln
Ste 101
Franklin, TN 37069
Phone (615) 591-0919

4720 Traders Way
Ste 800
Thompsons Station, TN 37179
Phone (615) 224-2479

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479427200000",
    "number": "1679671986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 STANSBERRY LANE",
            "address_2": "SUITE 101",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "37069",
            "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 LANE",
            "address_2": "SUITE 101",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "37069",
            "telephone_number": "615-591-0919",
            "fax_number": "615-599-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORAL AND FACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-11-18",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "615-591-0919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "8111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Oral and Facial Surgery",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Franklin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; 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.