Individual provider Active NPI

Horton Scott Li, DMD

  • Pediatric Dentistry
  • Lebanon, TN
National Provider Identifier
1083142483
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
TN10473 Issued in TN
Practice address
604 S Cumberland St Ste 200
Lebanon, TN 37087-4794
Phone
(615) 208-7286
NPI assigned
May 30, 2017
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X TN10473 TN Primary

Addresses

Primary practice location

604 S Cumberland St Ste 200
Lebanon, TN 37087-4794

Mailing address

5000 Crossings Cir Ste 301
Mt Juliet, TN 37122-8591
Phone (615) 754-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170907000642 TN Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4880967207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TN10473TNMDPediatric Dentist
10473TNMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Dental Alliance of Crossville, PLLC PastSince Oct 8, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1083142483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CROSSINGS CIR STE 301",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371228591",
            "telephone_number": "615-754-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S CUMBERLAND ST STE 200",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370874794",
            "telephone_number": "615-208-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "HORTON",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "TN10473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.