Farragut Dental Studio PLLC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

FARRAGUT DENTAL STUDIO PLLC

Practice address

11201 W Point Dr Ste 101
Farragut, TN 37934-2834

Phone

(865) 288-0416

Fax

(865) 288-7177

NPI assigned

Jan 17, 2020

Organization subpart

No

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

Authorized official

Name

Kairav Vyas, DDS

Title

Owner

Phone

(865) 288-0416

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1235769241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 W POINT DR STE 101",
            "city": "FARRAGUT",
            "state": "TN",
            "postal_code": "379342834",
            "telephone_number": "865-288-0416",
            "fax_number": "865-288-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 W POINT DR STE 101",
            "city": "FARRAGUT",
            "state": "TN",
            "postal_code": "379342834",
            "telephone_number": "865-288-0416",
            "fax_number": "865-288-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARRAGUT DENTAL STUDIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "VYAS",
        "authorized_official_first_name": "KAIRAV",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "865-288-0416",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Farragut Speech & Language LLC
• Kaitlyn Flickinger, DPT
• Elizabeth Schoudel Florek
• Kella Gerdeman, MS RD LD

• Oral and Maxillofacial Surgery Clinic/Center in Farragut, TN
• Providers in Farragut, TN by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.