Individual provider Active NPI

Cassidy Mangini, DDS

  • Dentist
  • Nolensville, TN
National Provider Identifier
1013802172
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12746 Issued in TN
Practice address
197 Burkitt Commons Ave
Nolensville, TN 37135-2965
Phone
(615) 257-5699
NPI assigned
Jun 10, 2025
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12746 TN Primary

Addresses

Primary practice location

197 Burkitt Commons Ave
Nolensville, TN 37135-2965

Mailing address

1055 Pine St Apt 707
Nashville, TN 37203-4465
Phone (980) 242-6008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250811002463 TN Order and Referring Only - DentistPractitioner - Dentist 5193223956

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12746TNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nolensville Smiles Dentistry, PC CurrentSince Jun 15, 2025 Accepting new patients

Networks

  • MS PPO C-SNP
  • MS PPO D-SNP

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1013802172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 PINE ST APT 707",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372034465",
            "telephone_number": "980-242-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 BURKITT COMMONS AVE",
            "city": "NOLENSVILLE",
            "state": "TN",
            "postal_code": "371352965",
            "telephone_number": "615-257-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGINI",
        "first_name": "CASSIDY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "12746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nolensville, TN

Sources for this page

Verify at the official NPI Registry.