NPIMap

Organization Active NPI

TW New Dentistry, PLLC

  • Dental Clinic/Center
  • Knoxville, TN
National Provider Identifier
1164189486
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TW NEW DENTISTRY, PLLC
Practice address
7828 Kingston Pike
Knoxville, TN 37919-5520
Phone
(865) 693-8131
NPI assigned
Nov 22, 2021
Organization subpart
Yes
Parent organization
TAILWATER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Mr. Ryan McCostlin
Title
Ceo
Phone
(615) 479-2196

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

7828 Kingston Pike
Knoxville, TN 37919-5520

Mailing address

10 Burton Hills Blvd Ste 400
Nashville, TN 37215-3004
Phone (615) 479-2196

Other names 1

  • New Dentistry Other name

National Provider Directory

National Provider Directory
Tax ID family
Tailwater Practice Partners11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

7828 Kingston Pike
Knoxville, TN 37919
Phone (865) 693-8131

Practitioners & affiliated clinicians

Practitioners 1

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": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1164189486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BURTON HILLS BLVD STE 400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372153004",
            "telephone_number": "615-479-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7828 KINGSTON PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195520",
            "telephone_number": "865-693-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TW NEW DENTISTRY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TAILWATER, LLC",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "MCCOSTLIN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-479-2196",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.