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

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

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 identifiers 4

Other names 1

• Associated Oral and Maxillofacial Surgeons Doing business as

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHAEL L HAMLIN IND. NPI",
            "identifier": "1154322451",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L ALAN BACON IND. NPI",
            "identifier": "1295736304",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN R COLLINS IND. NPI",
            "identifier": "1023019254",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARL W EILERS, JR IND NPI",
            "identifier": "1295736569",
            "state": "TN"
        }
    ],
    "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.