Mt Juliet Modern Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MT JULIET MODERN DENTISTRY PC

Doing business as

Mt Juliet Modern Dentistry

Practice address

600 S Mount Juliet Rd Ste 3
Mount Juliet, TN 37122-6497

Phone

(615) 716-1653

Fax

(615) 866-0615

NPI assigned

May 13, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Judge, DMD

Title

Owner

Phone

(615) 716-1653

Specialties & licenses 1

Addresses

Other names 1

• Mt Juliet Modern Dentistry Doing business as

Locations

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.

• Sophia Shi

  • General Practice Dentistry
  • Mount Juliet, TN
  • NPI 1316808637
  NPD

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1285371187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MOUNT JULIET RD STE 3",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371226497",
            "telephone_number": "615-716-1653",
            "fax_number": "615-866-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT JULIET MODERN DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "JUDGE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-716-1653",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt Juliet Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mt Juliet Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kayla Moyers
• Mt Juliet Chiropractic PC
• Mt Juliet Family Vision Center
• Mt Juliet Family Vision PC
• Mt Juliet Health Care Center LLC
• Mt. Juliet Counseling
• Mt. Juliet Dental Group, PC (Mt. Juliet Dental Group)
• Mt. Juliet Dental Studio PLLC
• Mt. Juliet Endodontics
• Mt. Juliet Family Care & Walk-in Clinic, LLC

• General Practice Dentistry in Mount Juliet, TN
• Providers in Mount Juliet, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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.