The Orthodontic Clinic, P.C.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS0000007616 Issued in TN

Legal business name

THE ORTHODONTIC CLINIC, P.C.

Practice address

6637 Summer Knoll Cir
Suite 102
Bartlett, TN 38134-2875

Phone

(901) 377-1744

Fax

(901) 507-4772

NPI assigned

Apr 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Adeola O. Faleye, D.M.D.NPI 1851389050

Title

Ceo, Owner

Phone

(901) 377-1744

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Adeola Olubukola Faleye, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bartlett, TN
  • NPI 1851389050
  NPD (past) Authorized official

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1063686772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6637 SUMMER KNOLL CIR",
            "address_2": "SUITE 102",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342875",
            "telephone_number": "901-377-1744",
            "fax_number": "901-507-4772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6637 SUMMER KNOLL CIR",
            "address_2": "SUITE 102",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342875",
            "telephone_number": "901-377-1744",
            "fax_number": "901-507-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ORTHODONTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "FALEYE",
        "authorized_official_first_name": "ADEOLA",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "CEO, OWNER",
        "authorized_official_telephone_number": "901-377-1744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS0000007616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3205648",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.