Spark Dental TN, PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

SPARK DENTAL TN, PLLC

Doing business as

Cumberland Pediatric Dentistry
Cumberland Pediatric Dentistry and Orthodontics
Tri-Cities Orthodontic Specialists

Practice address

1540 Rock Springs Rd
Smyrna, TN 37167-6141

Phone

(615) 930-3718

Fax

(615) 625-3473

NPI assigned

Nov 13, 2021

Last updated

Mar 11, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

SPARK DENTAL TN, PLLCAs reported in NPPES

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

Authorized official

Name

Carol Lynn Goings

Title

Regional Manager

Phone

(615) 478-7166

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 3

• Cumberland Pediatric Dentistry Doing business as
• Cumberland Pediatric Dentistry and Orthodontics Doing business as
• Tri-Cities Orthodontic Specialists Doing business as

Electronic endpoints 2

Part of

Spark Dental TN PLLC

Locations

Interoperability endpoints

• Direct secure messaging: kingsport@tnbraces.com

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daya Bhat, DDS MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Kingsport, TN
  • NPI 1124252697
  NPD (past)
• Nicholas Michael Carlson, DMD

  • Pediatric Dentistry
  • Clarksville, TN
  • NPI 1982349379
  NPD (past)
• Mallory Dawson, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Cookeville, TN
  • NPI 1629519525
  NPD (past)
• Anita Jennell Galloway, DDS

  • Pediatric Dentistry
  • Murfreesboro, TN
  • NPI 1174775068
  NPD (past)
• Latasha Michelle Garrett, DDS

  • Pediatric Dentistry
  • Clarksville, TN
  • NPI 1972919868
  NPD (past)
• Chauncey Allan Hensley, DMD

  • Pediatric Dentistry
  • Murfreesboro, TN
  • NPI 1063005106
  NPD (past)
• Joshua Christopher Jernigan, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Clarksville, TN
  • NPI 1043888118
  NPD (past)
• Ryann Luther, DDS

  • Pediatric Dentistry
  • Smyrna, TN
  • NPI 1376101535
  NPD (past)
• Carol Nixon, D.D.S.

  • Pediatric Dentistry
  • Columbia, TN
  • NPI 1154733509
  NPD (past)
• Nidhi Shah Patel, DDS

  • General Practice Dentistry
  • Columbia, TN
  • NPI 1245849090
  NPD (past)
• Ragab Rafa, DDS

  • Dentist
  • Columbia, TN
  • NPI 1649915372
  NPD (past)
• Jonathan Manuel Salinas, DDS

  • Pediatric Dentistry
  • Murfreesboro, TN
  • NPI 1225550965
  NPD (past)

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

{
    "created_epoch": "1636761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1154087120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 ROCK SPRINGS RD",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676141",
            "telephone_number": "615-930-3718",
            "fax_number": "615-625-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 ROCK SPRINGS RD",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676141",
            "telephone_number": "615-930-3718",
            "fax_number": "615-625-3473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Veterans Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371281077",
            "country_code": "US",
            "telephone_number": "615-713-1993",
            "fax_number": "615-203-3896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 Highway 76 Ste 9",
            "address_purpose": "LOCATION",
            "city": "White House",
            "state": "TN",
            "postal_code": "371888212",
            "country_code": "US",
            "telephone_number": "615-672-7221",
            "fax_number": "615-672-7211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "495 Dunlop Ln Ste 112",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370405296",
            "country_code": "US",
            "telephone_number": "931-221-0050",
            "fax_number": "931-221-0050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Liberty Pike Ste 217",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370675646",
            "country_code": "US",
            "telephone_number": "615-510-1151",
            "fax_number": "615-861-8790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "185 Prosser Rd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceburg",
            "state": "TN",
            "postal_code": "384644234",
            "country_code": "US",
            "telephone_number": "931-766-6670",
            "fax_number": "931-766-6920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "927 N James Campbell Blvd",
            "address_2": "STE 102 Building 1",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "TN",
            "postal_code": "38401",
            "country_code": "US",
            "telephone_number": "931-548-1333",
            "fax_number": "931-505-8118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "510 S Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385014010",
            "country_code": "US",
            "telephone_number": "931-854-1200",
            "fax_number": "931-854-1706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 Sheridan Sq Ste 400",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376607479",
            "country_code": "US",
            "telephone_number": "423-392-9898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPARK DENTAL TN, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPARK DENTAL TN, PLLC",
        "enumeration_date": "2021-11-13",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "GOINGS",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "615-478-7166"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q070323",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@cumberlandsmiles.com",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email correspondence",
            "address_1": "1540 Rock Springs Rd",
            "city": "Smyrna",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371676141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kingsport@TNBraces.com",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email correspondence",
            "address_1": "8 Sheridan Sq Ste 400",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376607479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Cumberland Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cumberland Pediatric Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cumberland Pediatric Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tri-Cities Orthodontic Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sos Buisness Trust (Stagner Orthopedic Services)
• Southern Pain Institute PLLC
• Sarah Sowell, CRNA
• Mackenzie Rose Sowers, MD
• Breanna Sox
• Jessica Erin Spas, PT, DPT
• Alexis Kylie Spence, PA
• Emily Spence
• Mark T, Spence, DPH
• Spero Health of Tennessee, LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.