NPIMap

Organization Active NPI

Erwin Dental, P.L.L.C.

  • General Practice Dentistry
  • Erwin, TN
National Provider Identifier
1154623411
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS8721 Issued in TN
Legal business name
ERWIN DENTAL, P.L.L.C.
Practice address
600 N Main Ave
Erwin, TN 37650-1392
Phone
(423) 743-6144
Fax
(423) 743-6884
NPI assigned
Nov 18, 2010
Last updated
Nov 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Authorized official

Name
Dr. Travis C. Wiles, D.D.S.
Title
Owner
Phone
(423) 743-6144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS8721 TN Primary

Addresses

Primary practice location

600 N Main Ave
Erwin, TN 37650-1392

Mailing address

600 N Main Ave
Erwin, TN 37650-1392
Phone (423) 743-6144

National Provider Directory

National Provider Directory

Locations

600 N Main Ave
Erwin, TN 37650
Phone (423) 743-6144

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1154623411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N MAIN AVE",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501392",
            "telephone_number": "423-743-6144",
            "fax_number": "423-743-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MAIN AVE",
            "city": "ERWIN",
            "state": "TN",
            "postal_code": "376501392",
            "telephone_number": "423-743-6144",
            "fax_number": "423-743-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERWIN DENTAL, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "WILES",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-743-6144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS8721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erwin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.