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STONECREST ORAL AND MAXILLOFACIAL SURGERY INC. NPI 1770514911


NPI Information

NPI: 1770514911
Provider Name: STONECREST ORAL AND MAXILLOFACIAL SURGERY, INC.
Classification: Clinic/Center - 261QS0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 44D1014942

Address:
STE 385
300 STONECREST BLVD
SMYRNA, TN
ZIP 37167
Phone: (615) 223-1200
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STONECREST ORAL AND MAXILLOFACIAL SURGERY, INC. is an oral and maxillofacial surgery clinic center in Smyrna, TN. The provider is an oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. STONECREST ORAL AND MAXILLOFACIAL SURGERY, INC. NPI is 1770514911. The provider is registered as an organization entity type.

The provider's business location address is:

STE 385
300 STONECREST BLVD
SMYRNA, TN
ZIP 37167-819
Phone: (615) 223-1200
Fax: (615) 223-1090

The provider's authorized official is Stone Crest Oral Maxillofa .
The authorized official title is Oral & Maxillofacial Surgeon and has the following contact phone number (615) 223-1200.

The CLIA number assigned to this NPI record is 44D1014942 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 12/5/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QS0112XClinic/CenterOral and Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13728862MEDICARE ID-TYPE UNSPECIFIEDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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