Provider Demographics
NPI:1730979949
Name:OAK RIDGE ENDODONTICS
Entity type:Organization
Organization Name:OAK RIDGE ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:865-978-6546
Mailing Address - Street 1:3248 TAZEWELL PIKE STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-2537
Mailing Address - Country:US
Mailing Address - Phone:865-978-6546
Mailing Address - Fax:
Practice Address - Street 1:689 EMORY VALLEY RD
Practice Address - Street 2:STE 101
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37918
Practice Address - Country:US
Practice Address - Phone:865-978-6546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty