Sandford Prince, DMD
Sandford Prince, DMD is a provider specialising in Oral and Maxillofacial Surgery (Dentist) in Johnson City, TN, registered under NPI 1790750586. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 2306 KNOB CREEK ROAD #108 KNOB CREEK ORAL CLINIC, Johnson City, TN 37604. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| DS0000009647 | TN | Oral and Maxillofacial Surgery (Dentist) primary |
This provider holds licence DS0000009647 issued in TN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Order And Referring Only - Oral Surgery
- PAC ID
- 4880917053
Medicare enrolment is recorded as approved under the provider type Order And Referring Only - Oral Surgery. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Oral and Maxillofacial Surgery covers
The specialty of dentistry which includes 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. NUCC Health Care Provider Taxonomy, code 1223S0112X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) Oral and Maxillofacial Surgery | DS0000009647 | TN | primary |
| 261QS0112X | Oral and Maxillofacial Surgery Clinic/Center Oral and Maxillofacial Surgery | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1790750586 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Feb 23, 2006 |
| Last updated | Mar 7, 2023 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | DMD |
| Practice address |
2306 KNOB CREEK ROAD #108 KNOB CREEK ORAL CLINIC Johnson City, TN 37604 (423) 467-5009 Fax (423) 467-5009 |
| Other identifiers |
12683544
· CAQH (TN) 465705259 · TENNESSEE (TN) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 7 | 9 | 0 | 7 | 5 | 0 | 5 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 7 | 9 | 0 | 5 | 5 | 0 | 5 | 7 |
Sum = 64 · next multiple of 10 = 70 · check digit = 6 · actual last digit = 6
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.