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EAST TENNESSEE ORAL AND MAXILLOFACIAL SURGERY, PC
NPI 1861701005
Dentist - Oral and Maxillofacial Surgery in Knoxville, TN

Active since October 06, 2010
161 CAPITAL DRIVE, SUITE102, KNOXVILLE, TN 37922(865) 531-3909(865) 539-0022 Get Directions Write a Review

NPPES record last updated: November 29, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About East Tennessee Oral And Maxillofacial Surgery, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST TENNESSEE ORAL AND MAXILLOFACIAL SURGERY, PC (NPI 1861701005) is a healthcare organization registered as an oral and maxillofacial surgery in Knoxville, Tennessee and active in the NPI registry since October 2010. The organization lists Mark M. Widloski, Owner, as its authorized official.

NPPES Registry Identity

NPI1861701005
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameEAST TENNESSEE ORAL AND MAXILLOFACIAL SURGERY, PC
Location Address161 CAPITAL DRIVE, SUITE102Knoxville, TN 37922-3357
Mailing Address1505 E Lamar Alexander PkwyMaryville, TN 37804-5131 · (865) 983-8630 · Fax (865) 981-4914
Phone(865) 531-3909
Fax(865) 539-0022
Organization SubpartNo
Authorized OfficialMark M. WidloskiOwner · (865) 983-8630
Enumeration DateOctober 6, 2010
Last NPPES UpdateNovember 29, 2010
✔ NPI 1861701005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in TN · 4711
Definition
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.
161 CAPITAL DRIVE, Knoxville, TN 37922
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Other Identifiers 2

Medicare NSC6452150007TN
Medicare PIN3205757TN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is East Tennessee Oral And Maxillofacial Surgery, PC's NPI number?

The NPI number for East Tennessee Oral And Maxillofacial Surgery, PC is 1861701005. It was assigned to this organization in the NPPES registry on October 6, 2010.

Where is East Tennessee Oral And Maxillofacial Surgery, PC located?

East Tennessee Oral And Maxillofacial Surgery, PC is located at 161 Capital Drive Suite102, Knoxville, TN 37922. The listed phone number is (865) 531-3909.

What is East Tennessee Oral And Maxillofacial Surgery, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

What insurance does East Tennessee Oral And Maxillofacial Surgery, PC accept?

Health plans from UnitedHealthcare list East Tennessee Oral And Maxillofacial Surgery, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for East Tennessee Oral And Maxillofacial Surgery, PC was last updated on November 29, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.