Individual provider Active NPI

Smita Borole

  • General Practice Dentistry
  • Knoxville, TN
National Provider Identifier
1194896639
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7796 Issued in TN
Practice address
11340 Parkside Dr
Suite 2110
Knoxville, TN 37934-1971
Phone
(800) 487-4867
Fax
(216) 593-7433
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7796 TN Primary

Addresses

Primary practice location

11340 Parkside Dr
Suite 2110
Knoxville, TN 37934-1971

Mailing address

PO Box 860036
Minneapolis, MN 55486-0036
Phone (800) 487-4867

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160617001450 TN Order and Referring Only - Other (Non-Physician) 9931490117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7796TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentalworks, Dr. Borole & Associates (Farragut), P.C. General Practice Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1194896639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860036",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860036",
            "telephone_number": "800-487-4867",
            "fax_number": "216-593-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 PARKSIDE DR",
            "address_2": "SUITE 2110",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379341971",
            "telephone_number": "800-487-4867",
            "fax_number": "216-593-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOROLE",
        "first_name": "SMITA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.