Spring Creek Pediatric Dentistry PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SPRING CREEK PEDIATRIC DENTISTRY PLLC

Practice address

2698 Townsend CT Ste a
Clarksville, TN 37043-2699

Phone

(931) 648-9930

Fax

(931) 444-3407

NPI assigned

Sep 26, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Kennedy Jr., DDSNPI 1629399647

Title

Dentist

Phone

(931) 206-0852

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Chambliss Kennedy Jr., DDS

  • Pediatric Dentistry
  • Clarksville, TN
  • NPI 1629399647
  NPD Authorized official

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1255816104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 TOWNSEND CT STE A",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432699",
            "telephone_number": "931-648-9930",
            "fax_number": "931-444-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 TOWNSEND CT STE A",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432699",
            "telephone_number": "931-648-9930",
            "fax_number": "931-444-3407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2485 Fort Campbell Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370427789",
            "country_code": "US",
            "telephone_number": "931-378-8588",
            "fax_number": "931-378-8589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPRING CREEK PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "931-206-0852",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101128960",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527793",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simon Martin Spilkin, MD
• Patrice M Spillane, M.A. CCC-SLP
• Ivy Marie Spiller
• Courtney Spivey
• Angie Spoonamore, RPH
• Spring Forth Counseling
• Spring Meadows Health Care Center LLC (Spring Meadows Health Care Center)
• Spring Meadows SNF Operations LLC (Spring Meadows Health and Rehabilitation)
• Jonathan Spurgeon, DMD
• Scarlett Spurgeon, OTR/L

• Dental Clinic/Center in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Dental Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.