NPIMap

Organization Active NPI

West Tennessee Dental Group

  • Dentist
  • Dyersburg, TN
National Provider Identifier
1275005415
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WEST TENNESSEE DENTAL GROUP
Practice address
174 Community Park Rd
Dyersburg, TN 38024-9243
Phone
(731) 285-8890
NPI assigned
Dec 28, 2018
Last updated
Dec 28, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Authorized official

Name
Brittany Howard
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

174 Community Park Rd
Dyersburg, TN 38024-9243

Mailing address

174 Community Park Rd
Dyersburg, TN 38024-9243
Phone (731) 285-8890

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of TN PC66 organizations share this tax ID, including this one
Part of
Heartland Dental Care of TN PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

174 Community Park Rd
Dyersburg, TN 38024
Phone (731) 285-8890

Practitioners & affiliated clinicians

Practitioners 1

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": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545955200000",
    "number": "1275005415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 COMMUNITY PARK RD",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380249243",
            "telephone_number": "731-285-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 COMMUNITY PARK RD",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380249243",
            "telephone_number": "731-285-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TENNESSEE DENTAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS PC",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyersburg, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.