NPIMap

Organization Active NPI

Tennessee Dental Professionals, PC

Doing business as Secret City Dental Care

  • General Practice Dentistry
  • Oak Ridge, TN
National Provider Identifier
1174000780
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TENNESSEE DENTAL PROFESSIONALS, PC
Doing business as
Secret City Dental Care
Practice address
349 S Illinois Ave Ste 300
Oak Ridge, TN 37830-6756
Phone
(217) 540-5100
NPI assigned
Jul 26, 2018
Last updated
Oct 2, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-8426

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

349 S Illinois Ave Ste 300
Oak Ridge, TN 37830-6756

Mailing address

351 S Illinois Ave
Oak Ridge, TN 37830-6756
Phone (865) 272-2806

Other names 1

  • Secret City Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Tennessee PC66 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Tennessee PC

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

349 S Illinois Ave
Ste 300
Oak Ridge, TN 37830

351 S Illinois Ave
Oak Ridge, TN 37830
Phone (865) 272-2806

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": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1174000780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 S ILLINOIS AVE",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306756",
            "telephone_number": "865-272-2806",
            "fax_number": "865-272-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 S ILLINOIS AVE STE 300",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306756",
            "telephone_number": "217-540-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8426"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Secret City Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Secret City Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.