NPIMap

Organization Active NPI

Hendersonville Family Dentistry, LLC

  • Dental Clinic/Center
  • Hendersonville, TN
National Provider Identifier
1215301460
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
HENDERSONVILLE FAMILY DENTISTRY, LLC
Practice address
230 New Shackle Island Rd Ste 170
Hendersonville, TN 37075-2485
Phone
(615) 822-8262
Fax
(615) 822-8682
NPI assigned
Nov 25, 2015
Last updated
Nov 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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

Authorized official

Name
Ms. Kelly J Deboer
Title
Office Manager
Phone
(615) 822-8262

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

230 New Shackle Island Rd Ste 170
Hendersonville, TN 37075-2485

Mailing address

230 New Shackle Island Rd Ste 170
Hendersonville, TN 37075-2485
Phone (615) 822-8262

National Provider Directory

National Provider Directory

Locations

230 New Shackle Island Rd
Ste 170
Hendersonville, TN 37075
Phone (615) 822-8262

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": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1215301460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 NEW SHACKLE ISLAND RD STE 170",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752485",
            "telephone_number": "615-822-8262",
            "fax_number": "615-822-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 NEW SHACKLE ISLAND RD STE 170",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752485",
            "telephone_number": "615-822-8262",
            "fax_number": "615-822-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSONVILLE FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "DEBOER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "615-822-8262",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; 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.