TRI-STATE ORAL SURGERY, LLC
NPI 1710366323
Dentist - Oral and Maxillofacial Surgery in Evansville, IN
NPI Status: Active since May 28, 2015
Contact Information
405 BENTEE WES CT
EVANSVILLE, IN
ZIP 47715
Phone: (812) 401-3500
Fax: (812) 401-3600
- Organization
- Dentist
- Oral and Maxillofacial Surgery
- CLIA Number: 15D2248889
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-17-2026
About TRI-STATE ORAL SURGERY, LLC
This page provides the complete NPI Profile along with additional information for Tri-state Oral Surgery, Llc, a provider established in Evansville, Indiana operating as a Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1710366323 assigned on May 2015. The practitioner's primary taxonomy code is 1223S0112X with license number 12009501A (IN). The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Mark E. Wohlford Dds, Phd (Owner)
- NPI
- 1710366323
- Provider Name
- TRI-STATE ORAL SURGERY, LLC
- Entity Type
- Organization
- Location Address
- 405 BENTEE WES CT EVANSVILLE, IN 47715
- Location Phone
- (812) 401-3500
- Location Fax
- (812) 401-3600
- Mailing Address
- 405 BENTEE WES CT EVANSVILLE, IN 47715
- Mailing Phone
- (812) 401-3500
- Mailing Fax
- (812) 401-3600
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-28-2015
- Last Update Date
- 05-28-2015
- Code Navigator
A dentist like Tri-state Oral Surgery, Llc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Oral and Maxillofacial Surgery
- Taxonomy Code
- 1223S0112X
- Type
- Dental Providers
- License No.
- 12009501A
- License State
- IN
- Taxonomy Description
- An oral and maxillofacial surgery dentist 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2248889
- Facility Type
- Physician Office
- Certificate Effective Date
- January 18, 2024
- Certificate Expiration Date
- January 17, 2026
- Laboratory Director
- JULIE NEWTON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Tri-state Oral Surgery, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 1 | 0 | 3 | 6 | 6 | 3 | 2 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 2 | 0 | 6 | 6 | 12 | 3 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 2 + 0 + 6 + 6 + 1 + 2 + 3 + 4 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1710366323 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
MR. STEVEN F RODGERS DDS
Dentist
(Oral and Maxillofacial Surgery)
405 BENTEE WES CT
EVANSVILLE, IN
ZIP 47715
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710366323, enumerated as an "organization" on May 28, 2015.
The provider is located at 405 BENTEE WES CT EVANSVILLE, IN 47715 and the phone number is (812) 401-3500.
Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.
