Organization Active NPI

McKenzie Oral and Facial Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Dickson, TN
National Provider Identifier
1922568666
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
MCKENZIE ORAL AND FACIAL SURGERY PLLC
Practice address
445 Henslee Dr
Dickson, TN 37055-2166
Phone
(615) 441-1441
Fax
(615) 441-1460
NPI assigned
Mar 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
William Stuart McKenzie, MD, DMDNPI 1932427317
Title
Owner
Phone
(615) 441-1441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

445 Henslee Dr
Dickson, TN 37055-2166

Mailing address

445 Henslee Dr
Dickson, TN 37055-2166
Phone (615) 441-1441

Other practice location 1

237 Dunbar Cave Rd Ste A
Clarksville, TN 37043-8852
Phone (615) 441-1441

Other practice location 2

7640 Highway 70 S Ste 104
Nashville, TN 37221-1758
Phone (615) 441-1441

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@midstateoralsurgery.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250203001006 TN Part B Supplier - Clinic/Group Practice 5991038523 Receives reassigned benefits from 7 practitioners
Practice locations: Clarksville, TN; Dickson, TN; Nashville, TN

National Provider Directory

National Provider Directory

Locations

237 Dunbar Cave Rd
Clarksville, TN 37043

445 Henslee Dr
Dickson, TN 37055
Phone (615) 441-1441

108 Sunset Rd
Ste A
Dickson, TN 37055
Phone (615) 441-1441

445 Henslee Dr
Ste 101
Dickson, TN 37055

3050 Business Park Cir
Ste 100
Goodlettsville, TN 37072
Phone (615) 859-0188

2574 Christmasville Cv
Jackson, TN 38305

7640 Highway 70 S
Ste 104
Nashville, TN 37221
Phone (615) 441-1441

1035 Nasdaq St
Spring Hill, TN 37174

Practitioners & affiliated clinicians

Practitioners 9

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": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1922568666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 HENSLEE DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552166",
            "telephone_number": "615-441-1441",
            "fax_number": "615-441-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 HENSLEE DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552166",
            "telephone_number": "615-441-1441",
            "fax_number": "615-441-1460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "237 Dunbar Cave Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370438852",
            "country_code": "US",
            "telephone_number": "615-441-1441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7640 Highway 70 S Ste 104",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372211758",
            "country_code": "US",
            "telephone_number": "615-441-1441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MCKENZIE ORAL AND FACIAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-441-1441",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@midstateoralsurgery.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "445 Henslee Dr",
            "city": "Dickson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370552166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dickson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.