Active NPI
Stephen Mitchell Speck, DDS
- General Practice Dentistry
- Hermitage, TN
National Provider Identifier
1083838965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3280
- Practice address
- 3515 Central Pike
Suite 201
Hermitage, TN 37076 - Phone
- (615) 883-3450
- Fax
- (615) 871-0988
- NPI assigned
- Apr 12, 2007
- Sex
- Male
- 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 | 3280 | TN | Primary |
Addresses
Primary practice location
3515 Central Pike
Suite 201
Hermitage, TN 37076
Mailing address
4047 Twin Oaks Lane
Cane Ridge, TN 37076
Phone (615) 641-7001
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 |
|---|---|---|---|
| 3280 | TN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083838965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4047 TWIN OAKS LANE",
"city": "CANE RIDGE",
"state": "TN",
"postal_code": "37076",
"telephone_number": "615-641-7001",
"fax_number": "615-871-0988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 CENTRAL PIKE",
"address_2": "SUITE 201",
"city": "HERMITAGE",
"state": "TN",
"postal_code": "37076",
"telephone_number": "615-883-3450",
"fax_number": "615-871-0988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPECK",
"first_name": "STEPHEN",
"middle_name": "MITCHELL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "3280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hermitage, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.