Maryville Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MARYVILLE DENTAL CARE

Practice address

1401 Montvale Station Rd
Maryville, TN 37803-5815

Phone

(865) 984-3800

NPI assigned

Sep 28, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Laura Bull

Title

Office

Phone

(865) 483-7851

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Maryville Dental Care Doing business as

Practitioners 3

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

• Paul Jeffrey Phillips, DDS

  • General Practice Dentistry
  • Oak Ridge, TN
  • NPI 1194792051
  NPD
• Erin Cummins Giacomini, D.M.D.

  • Dentist
  • Maryville, TN
  • NPI 1194923649
  NPD (past)
• Dana Short Riley

  • General Practice Dentistry
  • Knoxville, TN
  • NPI 1881190619
  NPD (past)

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1083338644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 LABORATORY RD STE 101",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306808",
            "telephone_number": "865-483-7851",
            "fax_number": "865-483-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MONTVALE STATION RD",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378035815",
            "telephone_number": "865-984-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYVILLE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "BULL",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OFFICE",
        "authorized_official_telephone_number": "865-483-7851",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1881190619",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryville Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca P Martin
• Stephenie Ann Martin, B.S.
• Tracy Dale Martin, PT, ATC
• Maryville Anesthesiologists PC
• Maryville ASC
• Maryville Dental, PLLC.
• Maryville Fairpark Opco LLC
• Maryville Foot Clinic Inc
• Maryville Jamestown Opco LLC
• Maryville Massage

• General Practice Dentistry in Maryville, TN
• Providers in Maryville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.