Dandridge Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

DANDRIDGE PEDIATRIC DENTISTRY

Practice address

117 E Price Rd
Dandridge, TN 37725-4513

Phone

(865) 940-1280

NPI assigned

May 28, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Victoria P Childers, MDNPI 1932550498

Title

Pediatric Dentist/Co-Owner

Phone

(865) 940-1280

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

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

• Victoria Paige Childers, D.M.D.

  • Pediatric Dentistry
  • Frankfort, KY
  • NPI 1932550498

  TN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1144844879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E PRICE RD",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377254513",
            "telephone_number": "865-940-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E PRICE RD",
            "city": "DANDRIDGE",
            "state": "TN",
            "postal_code": "377254513",
            "telephone_number": "865-940-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANDRIDGE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST/CO-OWNER",
        "authorized_official_telephone_number": "865-940-1280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q055235",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley Coffey, FNP
• Robin Herron Conard, PT
• Taylor Cooper
• Angele Cote, LMSW
• Candace Craig, SLP
• Dewayne Paschall Darby, M.D.
• Jessie Depew
• Kimberly Hope Devotie, L.P.N.
• Brandy Jean Dickson, OTA
• Donna R Dillard, M.D.

• Pediatric Dentistry in Dandridge, TN
• Providers in Dandridge, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.