Ccofs Oral Surgery 2 LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CCOFS ORAL SURGERY 2 LLC

Practice address

4103 E North St
Greenville, SC 29615-2350

Phone

(864) 268-6417

Fax

(864) 268-3200

NPI assigned

Sep 9, 2020

Last updated

Sep 9, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

DRS MISIEK, FARRELL, FARRELL, NALE, COOK, KAPITAN, MOHAMED & FRANCO PAAs reported in NPPES

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

Authorized official

Name

Mrs. Jennifer Rayle Hock

Title

Director of Billing

Phone

(704) 295-4653

Specialties & licenses 1

Addresses

Other names 1

• Carolinas Center for Oral & Facial Surgery Other name

Part of

DRS Spagnoli Tucker Crowley Galup Misiek and Gollehon

Locations

Practitioners 4

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.

• Ashley Cannon Tankersley, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Greenville, SC
  • NPI 1851730634
  NPD
• Sanjay Bhatt, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Simpsonville, SC
  • NPI 1124403407
  NPD (past)
• James B Tankersley Jr., DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Greenville, SC
  • NPI 1790720043
  NPD (past)
• Brannon Myrick

  • Oral and Maxillofacial Surgery (Dentist)
  • Jackson, MS
  • NPI 1700230083
  NPD (past)

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1700491685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7482 WATERSIDE CROSSING BLVD STE 101",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280373006",
            "telephone_number": "704-295-4653",
            "fax_number": "704-295-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 E NORTH ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296152350",
            "telephone_number": "864-268-6417",
            "fax_number": "864-268-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCOFS ORAL SURGERY 2 LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DRS MISIEK, FARRELL, FARRELL, NALE, COOK, KAPITAN, MOHAMED & FRANCO PA",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "HOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "RAYLE",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "704-295-4653",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolinas Center for Oral & Facial Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Catherine Cavender
• Mindy Lee Cavendish, M.S., CCC-SLP
• Nelson Johan Caviedes, CRNA
• Cbedrugs, LLC (Parker Road Drugstore)
• CCLC Obs LLC
• Ccofs Oral Surgery I, LLC (Carolinas Center for Oral & Facial Surgery)
• Adrick Dorell Ceasar, PT
• John E. Cebe, M.D.
• Lindsey Caston Cecil, MD
• Ashlie Pruett Ceips, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Greenville, SC
• Providers in Greenville, SC by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.