Philip Holden Bates, DMD – General Practice Dentistry

Key facts

NPI: 1194189795
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: DS0000010944 (TN)
Practice address: 1053 Hunters Xing
Alcoa, TN 37701-1854
Phone: (865) 223-6705
NPI assigned: Apr 9, 2016
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Maryville Modern Dentistry, PC Dentist · Alcoa, TN · NPI 1679056683

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
DS0000010944	TN	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Maryville Modern Dentistry, PC		Past since Jan 12, 2020	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	9758	KY
General Practice Dentistry	1223G0001X	DS0000010944	TN	Yes

Addresses

Primary practice location

1053 Hunters Xing
Alcoa, TN 37701-1854

Mailing address

889 Furlong Dr
Lexington, KY 40504-2341
Phone (865) 680-3341

Other practice location 1

2358 Nicholasville Rd Ste 155
Lexington, KY 40503-3041
Phone (859) 381-0680

Other providers in Alcoa, TN

All providers in Alcoa, TN · General Practice Dentistry in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.