Active NPI
Hixson Pediatric Dentistry PLLC
- Pediatric Dentistry
- Hixson, TN
National Provider Identifier
1063814838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DS0000004055
- Legal business name
- HIXSON PEDIATRIC DENTISTRY PLLC
- Practice address
- 5470 Hixson Pike Ste a
Hixson, TN 37343-3299 - Phone
- (423) 842-0165
- Fax
- (423) 842-7614
- NPI assigned
- Sep 23, 2014
- Last updated
- Sep 23, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hugh D Vice, D.D.S.,M.S.
- Title
- Senior Partner
- Phone
- (423) 842-0165
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DS0000004055 | TN | Primary |
Addresses
Primary practice location
5470 Hixson Pike Ste a
Hixson, TN 37343-3299
Mailing address
5470 Hixson Pike Ste a
Hixson, TN 37343-3299
Phone (423) 842-0165
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033370853 | Other | PERSONAL NPI | |
| DS0000004055 | Other | TN | DENTAL LICENSE |
| DS0000009112 | Other | TN | DENTAL LICENSE |
| 000338082B | Medicaid | GA | |
| 003126147A | Medicaid | GA | |
| 1528610 | Medicaid | TN | |
| 219618537A | Medicaid | GA | |
| 1529061 | Medicaid | TN | |
| DN014567 | Other | GA | DENTAL LICENSE |
| 1548273212 | Other | PERSONAL NPI | |
| 1851382592 | Other | PERSONAL NPI | |
| 1527928 | Medicaid | TN | |
| DS0000005135 | Other | TN | DENTAL LICENSE |
National Provider Directory
National Provider DirectoryLocations
5470 Hixson Pike
Ste A
Hixson, TN 37343
Phone (423) 842-0165
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pediatric Dentistry
- Hixson, TN
- NPI 1851382592
-
- Pediatric Dentistry
- Hixson, TN
- NPI 1033370853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1411430400000",
"number": "1063814838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5470 HIXSON PIKE STE A",
"city": "HIXSON",
"state": "TN",
"postal_code": "373433299",
"telephone_number": "423-842-0165",
"fax_number": "423-842-7614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5470 HIXSON PIKE STE A",
"city": "HIXSON",
"state": "TN",
"postal_code": "373433299",
"telephone_number": "423-842-0165",
"fax_number": "423-842-7614"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HIXSON PEDIATRIC DENTISTRY PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-09-23",
"last_updated": "2014-09-23",
"status": "A",
"authorized_official_last_name": "VICE",
"authorized_official_first_name": "HUGH",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "SENIOR PARTNER",
"authorized_official_telephone_number": "423-842-0165",
"authorized_official_credential": "D.D.S.,M.S."
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "TN",
"license": "DS0000004055",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL NPI",
"identifier": "1033370853",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "DS0000004055",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "DS0000009112",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000338082B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003126147A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1528610",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "219618537A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1529061",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "DN014567",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL NPI",
"identifier": "1548273212",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL NPI",
"identifier": "1851382592",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1527928",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "DS0000005135",
"state": "TN"
}
],
"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 Sep 23, 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.