NPIMap

Organization Active NPI

Premier Family Dental

  • Dental Clinic/Center
  • Hixson, TN
National Provider Identifier
1043617657
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
9373 Issued in TN
Legal business name
PREMIER FAMILY DENTAL
Practice address
1963 Northpoint Blvd
Suite 113
Hixson, TN 37343-4631
Phone
(423) 551-3373
NPI assigned
Nov 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Authorized official

Name
Dr. Kathryn Rae Egan, DDSNPI 1790911014
Title
Sole Member
Phone
(423) 505-3750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 9373 TN Primary

Addresses

Primary practice location

1963 Northpoint Blvd
Suite 113
Hixson, TN 37343-4631

Mailing address

1963 Northpoint Blvd
Suite 113
Hixson, TN 37343-4631

National Provider Directory

National Provider Directory

Locations

1963 Northpoint Blvd
Ste 113
Hixson, TN 37343
Phone (423) 551-3373

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": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1043617657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1963 NORTHPOINT BLVD",
            "address_2": "SUITE 113",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 NORTHPOINT BLVD",
            "address_2": "SUITE 113",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434631",
            "telephone_number": "423-551-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "423-505-3750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "9373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.