Knoxville Center for Oral & Maxillofacial Surgery, PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

KNOXVILLE CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PC

Practice address

4533 Papermill Road
Oak Ridge, TN 37830

Phone

(865) 410-3075

Fax

(865) 674-5122

NPI assigned

Mar 12, 2018

Organization subpart

No

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

Authorized official

Name

Nicole Eisenberg

Title

Owner

Phone

(865) 410-3075

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540339200000",
    "number": "1891298337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 PAPERMILL ROAD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "37830",
            "telephone_number": "865-410-3075",
            "fax_number": "865-674-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4533 PAPERMILL ROAD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "37830",
            "telephone_number": "865-410-3075",
            "fax_number": "865-674-5122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Laboratory Rd",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378306802",
            "country_code": "US",
            "telephone_number": "865-410-3075",
            "fax_number": "865-481-3067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KNOXVILLE CENTER FOR ORAL & MAXILLOFACIAL SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2018-10-24",
        "status": "A",
        "authorized_official_last_name": "EISENBERG",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-410-3075"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Marie Kimbrel, LCSW
• Lacey King, CRNA
• Meridith Elise Hawkins King, DO
• Amy Elizabeth Knapp, PT, DPT
• Adrian Weldon Knauss, PHD, LMFT
• David Werner Koelsch, MD
• Christopher N Koontz, LCSW
• Bernadette Kos, MA
• Lalita Krishnan, M.D.
• Kroger Limited Partnership I

• All providers in Oak Ridge, TN
• Oral and Maxillofacial Surgery Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.