Southeast Oral Surgery PC

Key facts

NPI

1952547366

Entity type

Organization (NPI type 2)

Primary specialty

Oral and Maxillofacial Surgery (Dentist) 1223S0112X

Legal business name

SOUTHEAST ORAL SURGERY PC

Practice address

801 W Oldham Ave
Knoxville, TN 37921-2747

Phone

(865) 522-1244

Fax

(865) 525-7041

NPI assigned

Jan 7, 2009

Organization subpart

No

Authorized official

Name

Timothy McConnell, DDS

Title

Partner

Phone

(865) 977-7110

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tonya Lynn Carson, RDH Dental Hygienist · Knoxville, TN · NPI 1275232225
  NPD (past)
• Richard Myers III, D.D.S. General Practice Dentistry · Knoxville, TN · NPI 1760565659
  NPD (past)
• Thomas Andrew Sharp, D.D.S. General Practice Dentistry · Knoxville, TN · NPI 1487737128
  NPD (past)
• George Joshua Steedley, DMD Dentist · Knoxville, TN · NPI 1457507212
  NPD (past)

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 15, 2009.

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239753600000",
    "number": "1952547366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1858 CREST RD",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378044305",
            "telephone_number": "865-977-7110",
            "fax_number": "865-977-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W OLDHAM AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379212747",
            "telephone_number": "865-522-1244",
            "fax_number": "865-525-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-04-15",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "865-977-7110",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southeast Oral Surgery PC
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• Southeast Tennessee Health Clinic, LLC

All providers in Knoxville, TN · Oral and Maxillofacial Surgery (Dentist) in Tennessee