Active NPI
Tanya Wadhwa
- General Practice Dentistry
- Brentwood, TN
National Provider Identifier
1083306468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4782
- Practice address
- 1216 General McArthur Dr
Brentwood, TN 37027-6609 - Phone
- (314) 795-3115
- NPI assigned
- May 23, 2023
- Last updated
- Aug 30, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4782 | AR | Primary |
Addresses
Primary practice location
1216 General McArthur Dr
Brentwood, TN 37027-6609
Mailing address
1216 General McArthur Dr
Brentwood, TN 37027-6609
Phone (314) 795-3115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4782 | AR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724976000000",
"number": "1083306468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1216 GENERAL MCARTHUR DR",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370276609",
"telephone_number": "314-795-3115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1216 GENERAL MCARTHUR DR",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370276609",
"telephone_number": "314-795-3115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADHWA",
"first_name": "TANYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-23",
"last_updated": "2024-08-30",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "4782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.