NPIMap

Organization Active NPI

Farragut Modern Dentistry, PC

Doing business as Farragut Modern Dentistry

  • Dentist
  • Farragut, TN
National Provider Identifier
1073087714
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
FARRAGUT MODERN DENTISTRY, PC
Doing business as
Farragut Modern Dentistry
Practice address
109 Campbell Station Rd.
Farragut, TN 37934
Phone
(865) 622-8898
NPI assigned
Jan 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Dr. John Harrison, DDS
Title
Owner/DDS
Phone
(865) 622-8898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

109 Campbell Station Rd.
Farragut, TN 37934

Mailing address

PO Box 920050
Dallas, TX 75392-0050

Other names 1

  • Farragut Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

109 S Campbell Station Rd
Farragut, TN 37934
Phone (503) 939-2753

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": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1073087714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CAMPBELL STATION RD.",
            "city": "FARRAGUT",
            "state": "TN",
            "postal_code": "37934",
            "telephone_number": "865-622-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARRAGUT MODERN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "865-622-8898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farragut Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Farragut Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farragut, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.