Oral Pathology Diagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

44D2016339 Issued in TN

Legal business name

ORAL PATHOLOGY DIAGNOSTICS

Practice address

2440 Edencrest Dr
Antioch, TN 37013-1919

Phone

(615) 480-6800

NPI assigned

Jan 7, 2011

Organization subpart

No

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

Authorized official

Name

Tanya M Gibson, DDS

Title

President

Phone

(615) 480-6800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294358400000",
    "number": "1699079491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10076",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914100076",
            "telephone_number": "805-578-8300",
            "fax_number": "805-578-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 EDENCREST DR",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370131919",
            "telephone_number": "615-480-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL PATHOLOGY DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-480-6800",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "44D2016339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Open Arms Care Corporation
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• Open Arms Care Corporation
• Optimal Services LLC
• Katie J Ortiz
• Victoria Oghenevwaire Osobase, R.N
• Jalexius Ericalachelle Otey
• Zonelle L Ottley
• Nerea Ann Ouma, NURSE PRACTIONER

• Clinical Medical Laboratory in Antioch, TN
• Providers in Antioch, TN by specialty
• Clinical Medical Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; 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.