NPIMap

Organization Active NPI

Loudon Dental Arts, PLLC

  • General Practice Dentistry
  • Loudon, TN
National Provider Identifier
1124788906
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LOUDON DENTAL ARTS, PLLC
Practice address
705 Mulberry St.
Loudon, TN 37774
Phone
(865) 458-4396
Fax
(865) 458-4605
NPI assigned
Dec 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Authorized official

Name
Mr. Scott Allen Walters, DDSNPI 1144230574
Title
Owner
Phone
(865) 458-4396

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

705 Mulberry St.
Loudon, TN 37774

Mailing address

705 Mulberry St.
Loudon, TN 37774
Phone (865) 458-4396

National Provider Directory

National Provider Directory
Tax ID family
Loudon Dental Arts PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

705 Mulberry St
Loudon, TN 37774
Phone (865) 458-4396

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1124788906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 MULBERRY ST.",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "37774",
            "telephone_number": "865-458-4396",
            "fax_number": "865-458-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MULBERRY ST.",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "37774",
            "telephone_number": "865-458-4396",
            "fax_number": "865-458-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUDON DENTAL ARTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-21",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-458-4396",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loudon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.