Active NPI
Jean-Max Jean-Pierre, DDS MDS
- Periodontics
- Hendersonville, TN
National Provider Identifier
1164547139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS0000008167
- Practice address
- 100 Springhouse CT.
Suite 220
Hendersonville, TN 37075 - Phone
- (615) 264-6404
- Fax
- (615) 264-0689
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DS0000008167 | TN | Primary |
Addresses
Primary practice location
100 Springhouse CT.
Suite 220
Hendersonville, TN 37075
Mailing address
1779 Kirby Pkwy # 14716
Memphis, TN 38138-3666
Phone (629) 777-6455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150713001857 | TN | Order and Referring Only - Oral Surgery | 4284947789 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS0000008167 | TN | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Periodontal & Implant Associates of Middle Tennessee, PLLC | Periodontics | Past | Accepting new patients |
| Periodontal Care Center, PLLC | Periodontics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Periodontics
- Hendersonville, TN
- NPI 1659668226
-
- Periodontics
- Hendersonville, TN
- NPI 1689213902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581033600000",
"number": "1164547139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1779 KIRBY PKWY # 14716",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381383666",
"telephone_number": "629-777-6455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 SPRINGHOUSE CT.",
"address_2": "SUITE 220",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "37075",
"telephone_number": "615-264-6404",
"fax_number": "615-264-0689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEAN-PIERRE",
"first_name": "JEAN-MAX",
"name_prefix": "Dr.",
"credential": "DDS MDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2020-02-07",
"certification_date": "2020-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TN",
"license": "DS0000008167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.