NPIMap

Organization Active NPI

Beech Lake Pediatric Dentistry, PLC

  • Pediatric Dentistry
  • Lexington, TN
National Provider Identifier
1275893406
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D8508 Issued in TN
Legal business name
BEECH LAKE PEDIATRIC DENTISTRY, PLC
Practice address
10855 Highway 412 W
Lexington, TN 38351-6283
Phone
(731) 968-5437
Fax
(731) 968-5439
NPI assigned
May 22, 2012
Last updated
May 22, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Authorized official

Name
Dr. Tommy Burke, DDSNPI 1417078726
Title
Owner/Dentist
Phone
(731) 968-5437

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X D8508 TN Primary

Addresses

Primary practice location

10855 Highway 412 W
Lexington, TN 38351-6283

Mailing address

10855 Highway 412 W
PO Box 556
Lexington, TN 38351-6283
Phone (731) 968-5437

National Provider Directory

National Provider Directory

Locations

10855 Highway 412 W
Lexington, TN 38351
Phone (731) 968-5437

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": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1275893406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10855 HIGHWAY 412 W",
            "address_2": "PO BOX 556",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383516283",
            "telephone_number": "731-968-5437",
            "fax_number": "731-968-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10855 HIGHWAY 412 W",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "383516283",
            "telephone_number": "731-968-5437",
            "fax_number": "731-968-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEECH LAKE PEDIATRIC DENTISTRY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "TOMMY",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "731-968-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "D8508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; 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.