NPIMap

Organization Active NPI

Hermitage Pediatric Dentistry, PLLC

Doing business as Zoo Crew Pediatric Dentistry

  • Pediatric Dentistry
  • Mount Juliet, TN
National Provider Identifier
1285176982
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
HERMITAGE PEDIATRIC DENTISTRY, PLLC
Doing business as
Zoo Crew Pediatric Dentistry
Practice address
2025 N Mount Juliet Rd Ste 110
Mount Juliet, TN 37122-3934
Phone
(615) 553-2921
Fax
(615) 316-9197
NPI assigned
Nov 11, 2016
Last updated
Dec 5, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
HERMITAGE PEDIATRIC DENTSITRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Authorized official

Name
Ms. Jenni Snow
Title
Credentialing Coordinator
Phone
(404) 410-1340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

2025 N Mount Juliet Rd Ste 110
Mount Juliet, TN 37122-3934

Mailing address

2025 N Mount Juliet Rd Ste 110
Mount Juliet, TN 37122-3934
Phone (404) 410-1340

Other names 1

  • Zoo Crew Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hermitage Pediatric Dentistry PLLC3 organizations share this tax ID, including this one
Part of
Hermitage Pediatric Dentistry PLLC

Other organizations with this tax ID 2

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

Locations

2025 N Mount Juliet Rd
Ste 110
Mt Juliet, TN 37122
Phone (615) 553-2921

Practitioners & affiliated clinicians

Practitioners 3

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": "1478822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1285176982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 N MOUNT JULIET RD STE 110",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223934",
            "telephone_number": "404-410-1340",
            "fax_number": "404-410-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 N MOUNT JULIET RD STE 110",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223934",
            "telephone_number": "615-553-2921",
            "fax_number": "615-316-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMITAGE PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERMITAGE PEDIATRIC DENTSITRY",
        "enumeration_date": "2016-11-11",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "SNOW",
        "authorized_official_first_name": "JENNI",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "404-410-1340",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zoo Crew Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.