NPIMap

Organization Active NPI

Periodontal & Implant Associates of Middle Tennessee, PLLC

  • Periodontics
  • Nashville, TN
National Provider Identifier
1174952642
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS007739 Issued in TN
Legal business name
PERIODONTAL & IMPLANT ASSOCIATES OF MIDDLE TENNESSEE, PLLC
Practice address
4205 Hillsboro Pike
Ste. 101
Nashville, TN 37215-3381
Phone
(615) 297-8973
Fax
(615) 297-6603
NPI assigned
Nov 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Authorized official

Name
Dr. Robert P Pulliam, DMD, MSNPI 1518064401
Title
Periodontist/Owner
Phone
(615) 297-8973

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X DS007739 TN Primary

Addresses

Primary practice location

4205 Hillsboro Pike
Ste. 101
Nashville, TN 37215-3381

Mailing address

4205 Hillsboro Pike
Ste. 101
Nashville, TN 37215-3381
Phone (615) 297-8973

National Provider Directory

National Provider Directory
Tax ID family
Periodontal Implant Associates of Middle Tennessee PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

4205 Hillsboro Pike
Ste 101
Nashville, TN 37215
Phone (615) 297-8973

Practitioners & affiliated clinicians

Practitioners 4

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": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1174952642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 HILLSBORO PIKE",
            "address_2": "STE. 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372153381",
            "telephone_number": "615-297-8973",
            "fax_number": "615-297-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 HILLSBORO PIKE",
            "address_2": "STE. 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372153381",
            "telephone_number": "615-297-8973",
            "fax_number": "615-297-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL & IMPLANT ASSOCIATES OF MIDDLE TENNESSEE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "PULLIAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PERIODONTIST/OWNER",
        "authorized_official_telephone_number": "615-297-8973",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "DS007739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.