Brite Smilez Cosmetic & Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

DS2859 Issued in TN

Legal business name

BRITE SMILEZ COSMETIC & FAMILY DENTISTRY

Practice address

5245 Hickory Hollow Pkwy
Antioch, TN 37013-3003

Phone

(615) 866-9109

Fax

(615) 866-9147

NPI assigned

Sep 25, 2008

Last updated

Aug 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Dionne McClain, R.D.H

Title

Dental Hygienist/ Office Manager

Phone

(615) 866-9109

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1083864102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 HICKORY HOLLOW PKWY",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133003",
            "telephone_number": "615-866-9109",
            "fax_number": "615-866-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5245 HICKORY HOLLOW PKWY",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133003",
            "telephone_number": "615-866-9109",
            "fax_number": "615-866-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRITE SMILEZ COSMETIC & FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "MCCLAIN",
        "authorized_official_first_name": "DIONNE",
        "authorized_official_title_or_position": "DENTAL HYGIENIST/ OFFICE MANAGER",
        "authorized_official_telephone_number": "615-866-9109",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.D.H"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS2859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440696",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517984",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q014905",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Antioch, TN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.