Lebanon Pediatric Dentistry, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

LEBANON PEDIATRIC DENTISTRY, LLC

Practice address

920 S Hartmann Dr
Lebanon, TN 37090-4018

Phone

(404) 410-1340

NPI assigned

Nov 7, 2019

Last updated

Nov 7, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Sims

Title

Credentialing Coordinator

Phone

(470) 552-1823

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1285279836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S HARTMANN DR",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370904018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S HARTMANN DR",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370904018",
            "telephone_number": "404-410-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "470-552-1823"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lebanon Health Care Center
• Lebanon Hma Physician Management LLC
• Lebanon Hma Surgery Center Inc (Lebanon Surgical Center)
• Lebanon Hma, LLC (University Medical Center)
• Lebanon Operator LLC (Wilson Manor)
• Lebanon Pet Scan Center, LLC
• Lebanon Radiation Oncology Center
• Lebanon Special School District
• Lebanon Surgicenter, LLC (Lebanon Center for Outpatient Surgery)
• Jodi Ledford, NP

• Pediatric Dentistry in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.