NPIMap

Organization Active NPI

Tennessee Dental Professionals PC

  • Dentist
  • Lebanon, TN
National Provider Identifier
1013312941
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9923 Issued in TN
Legal business name
TENNESSEE DENTAL PROFESSIONALS PC
Practice address
1715 W Main St
Lebanon, TN 37087-3153
Phone
(615) 547-3597
NPI assigned
Nov 4, 2014
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
Allison Varner
Title
Credentialing Coordinator
Phone
(217) 540-6077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 9923 TN Primary

Addresses

Primary practice location

1715 W Main St
Lebanon, TN 37087-3153

Mailing address

1715 W Main St
Lebanon, TN 37087-3153
Phone (615) 547-3597

Other names 1

  • Lebanon Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of TN PC66 organizations share this tax ID, including this one
Part of
Heartland Dental Care of TN PC

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

1715 W Main St
Lebanon, TN 37087
Phone (615) 547-3597

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1013312941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 W MAIN ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873153",
            "telephone_number": "615-547-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 W MAIN ST",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873153",
            "telephone_number": "615-547-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE DENTAL PROFESSIONALS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS PC",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "VARNER",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6077"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "9923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lebanon Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.