Individual provider Active NPI

Jean-Max Jean-Pierre, DDS MDS

  • Periodontics
  • Hendersonville, TN
National Provider Identifier
1164547139
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS0000008167 Issued in TN
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

Updated by the provider on Feb 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150713001857 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4284947789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS0000008167TNMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Periodontal & Implant Associates of Middle Tennessee, PLLC Periodontics PastSince Jan 5, 2020 Accepting new patients
Periodontal Care Center, PLLC Periodontics PastSince Jun 15, 2006 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.

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

Verify at the official NPI Registry.