L Alan Bacon DDS PC & John Collins DDS PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

L ALAN BACON DDS PC & JOHN COLLINS DDS PC

Doing business as

Associated Oral and Maxillofacial Surgeons

Practice address

117 W Sevier Ave
Suite 220
Kingsport, TN 37660-3799

Phone

(423) 224-3200

Fax

(423) 224-3208

NPI assigned

Aug 9, 2005

Last updated

Mar 1, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Donna L Fuller

Title

Office Manager

Phone

(423) 224-3200

Specialties & licenses 1

Addresses

Other names 1

• Associated Oral and Maxillofacial Surgeons Doing business as

Locations

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1972504389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W SEVIER AVE",
            "address_2": "SUITE 220",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603799",
            "telephone_number": "423-224-3200",
            "fax_number": "423-224-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W SEVIER AVE",
            "address_2": "SUITE 220",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603799",
            "telephone_number": "423-224-3200",
            "fax_number": "423-224-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L ALAN BACON DDS PC & JOHN COLLINS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "423-224-3200",
        "authorized_official_name_prefix": "Ms."
    },
    "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": [
        {
            "organization_name": "Associated Oral and Maxillofacial Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evan Loren Kulbacki, MD
• April Kuntz, M.S.CCC/SLP
• Stanley J Kupchinsky, CRNA
• Ittamveetil Narayanan Kutty, MD
• Kwick Transport, Inc.
• Jessica D La Count
• Laboratory Corporation of America Holdings
• Laura Lacey, PHARMD
• Herbert D Ladley, MD
• Sharon Elaine Lail, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.