NPIMap

Organization Active NPI

Abc Family Dental Center P.C.

  • General Practice Dentistry
  • Clarksville, TN
National Provider Identifier
1063595692
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7784 Issued in TN
Legal business name
ABC FAMILY DENTAL CENTER P.C.
Practice address
1877 Fort Campbell Blvd
Clarksville, TN 37042-5109
Phone
(931) 648-0191
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Authorized official

Name
Heath Cunningham, DDSNPI 1245220961
Title
Owner
Phone
(931) 648-0191

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7784 TN Primary

Addresses

Primary practice location

1877 Fort Campbell Blvd
Clarksville, TN 37042-5109

Mailing address

1877 Fort Campbell Blvd
Clarksville, TN 37042-5109
Phone (931) 648-0191

National Provider Directory

National Provider Directory

Locations

1877 Fort Campbell Blvd
Clarksville, TN 37042
Phone (931) 648-0191

Practitioners & affiliated clinicians

Practitioners 3

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": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1063595692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1877 FORT CAMPBELL BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370425109",
            "telephone_number": "931-648-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1877 FORT CAMPBELL BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370425109",
            "telephone_number": "931-648-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC FAMILY DENTAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "HEATH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-648-0191",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.