MEDICARE: WEST ESSEX ORAL SURGERY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)

General Provider Information

NPI Number	:	1841157153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST ESSEX ORAL SURGERY, PLLC

Provider Business Mailing Address
First Line	:	445 HENSLEE DR
Second Line	:
City	:	DICKSON
State	:	TN
Zip	:	37055-2166
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 MARSTON ST STE 203
Second Line	:
City	:	LAWRENCE
State	:	MA
Zip	:	01841-2357
Country	:	US
Telephone Number	:	205-617-7035
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM STUART MCKENZIE
Credential	:	DMD, MD
Telephone Number	:	615-441-1441

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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