NPIMap

Organization Active NPI

Prosperity Cosmetic & General Dentistry

  • Exclusive Provider Organization
  • Nashville, TN
National Provider Identifier
1275707853
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
8455 Issued in TN
Legal business name
PROSPERITY COSMETIC & GENERAL DENTISTRY
Practice address
908 34TH Ave N
Suite a
Nashville, TN 37209-2502
Phone
(615) 720-3765
Fax
(615) 327-0546
NPI assigned
Apr 15, 2008
Last updated
Apr 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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

Authorized official

Name
Dr. Brenda Lesia Moore II, DDSNPI 1477690246
Title
Dentist
Phone
(615) 720-3765

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 8455 TN Primary

Addresses

Primary practice location

908 34TH Ave N
Suite a
Nashville, TN 37209-2502

Mailing address

908 34TH Ave N
Suite a
Nashville, TN 37209-2502
Phone (615) 720-3765

Other identifiers 1

IdentifierTypeStateIssuer
5440336MedicaidTN

National Provider Directory

National Provider Directory

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": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1275707853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 34TH AVE N",
            "address_2": "SUITE A",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372092502",
            "telephone_number": "615-720-3765",
            "fax_number": "615-327-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 34TH AVE N",
            "address_2": "SUITE A",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372092502",
            "telephone_number": "615-720-3765",
            "fax_number": "615-327-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY COSMETIC & GENERAL DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LESIA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "615-720-3765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TN",
            "license": "8455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440336",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.