Woodbury Dental Partners

Primary specialty

DentistTaxonomy code 122300000X

License

DS10095 Issued in TN

Legal business name

WOODBURY DENTAL PARTNERS

Practice address

801 W Main St
Suite B
Woodbury, TN 37190-1047

Phone

(615) 563-2266

Fax

(615) 563-4258

NPI assigned

Aug 10, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher Clark, D.D.S.

Title

Dentist

Phone

(615) 563-2266

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1003360793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W MAIN ST",
            "address_2": "SUITE B",
            "city": "WOODBURY",
            "state": "TN",
            "postal_code": "371901047",
            "telephone_number": "615-563-2266",
            "fax_number": "615-563-4258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAIN ST",
            "address_2": "SUITE B",
            "city": "WOODBURY",
            "state": "TN",
            "postal_code": "371901047",
            "telephone_number": "615-563-2266",
            "fax_number": "615-563-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBURY DENTAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "615-563-2266",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS10095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Woodbury, TN
• Providers in Woodbury, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.