Kenneth L Schenck Jr., DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS1883 Issued in TN

Practice address

4845 Hixson Pike Ste a
Hixson, TN 37343-4466

Phone

(423) 875-4812

Fax

(423) 875-4814

NPI assigned

Oct 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Brian K Schenck Oral Surgery, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Hixson, TN
  • NPI 1720250954
  NPD (past)

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689664757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1446",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435446",
            "telephone_number": "423-875-4812",
            "fax_number": "423-875-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 HIXSON PIKE STE A",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434466",
            "telephone_number": "423-875-4812",
            "fax_number": "423-875-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENCK",
        "first_name": "KENNETH",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS1883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440298",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanne Andree Scanland, MD
• Elizabeth Erin Scarbrough, D.O.
• Scenic City Oral Surgery, PLLC
• Scenic City Pediatric Therapy LLC
• Brian K Schenck, DDS
• Linda D Schock
• Tracy Deborah Schultz, PSYD
• Aaron Robert Schumacher, ATC
• Chelsea Southerland Schwind, DDS
• Wayne T Scott, MD

• Oral and Maxillofacial Surgery (Dentist) in Hixson, TN
• Providers in Hixson, 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 Jul 8, 2007; 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.