NPIMap

Organization Active NPI

Tailwater Practice Partners

Doing business as Patriot Dental

  • General Practice Dentistry
  • Lebanon, TN
National Provider Identifier
1255139291
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TAILWATER PRACTICE PARTNERS
Doing business as
Patriot Dental
Practice address
99 Signature PL
Lebanon, TN 37087-3285
Phone
(615) 444-2034
NPI assigned
Mar 5, 2025
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
TAILWATER PRACTICE PARTNERS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Hillary Harris
Title
RCM Manager
Phone
(912) 270-0920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

99 Signature PL
Lebanon, TN 37087-3285

Mailing address

619 Gallant Way
Murfreesboro, TN 37129-4267
Phone (912) 270-0920

Other names 1

  • Patriot Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
TW Practice Partners PLLC11 organizations share this tax ID, including this one
Part of
TW Practice Partners PLLC

Other organizations with this tax ID 10

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

Locations

99 Signature Pl
Lebanon, TN 37087
Phone (615) 444-2034

NPI Registry JSON

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

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1255139291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 GALLANT WAY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371294267",
            "telephone_number": "912-270-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 SIGNATURE PL",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873285",
            "telephone_number": "615-444-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAILWATER PRACTICE PARTNERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TAILWATER PRACTICE PARTNERS, PLLC",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "912-270-0920"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patriot Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.