Andrew Tyler Ray, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10899 Issued in SC

Practice address

2817 Rock Merritt Avenue Womack Oral Surgery Clinic
Fort Liberty, NC 28310-6015

Phone

(910) 907-6974

NPI assigned

Apr 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1932763893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 COLONY LN NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373127506",
            "telephone_number": "423-284-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVENUE WOMACK ORAL SURGERY CLINIC",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283106015",
            "telephone_number": "910-907-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "ANDREW",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-26",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "0000011015",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "0000011015",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "10899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlton Trent Pyant, PH.D.
• Linzi Ralph, DMD
• Kyle Arthur Ramsey, PTA
• Sean Michael Robert Ramsey, DO
• Sarah Nicole Rappach, OD
• Charlotte Marie Reasor, PHYSICAL THERAPIST
• Monica Regan
• Erik Francis Reifenstahl, DMD
• Sharon Eileen Reynolds, AUD
• Mary Richardson, RN

• Oral and Maxillofacial Surgery (Dentist) in Fort Liberty, NC
• Providers in Fort Liberty, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.