NPIMap

Organization Active NPI

Lebanon Family Dentistry LLC

  • General Practice Dentistry
  • Lebanon, TN
National Provider Identifier
1295593457
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LEBANON FAMILY DENTISTRY LLC
Practice address
1430 W Baddour Pkwy Ste B
Lebanon, TN 37087-2656
Phone
(931) 704-0834
NPI assigned
Mar 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Robin Ricardo Daniel, MD, DDS
Title
Owner
Phone
(615) 830-2176

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X

Addresses

Primary practice location

1430 W Baddour Pkwy Ste B
Lebanon, TN 37087-2656

Mailing address

1430 W Baddour Pkwy Ste B
Lebanon, TN 37087-2656
Phone (931) 704-0834

National Provider Directory

National Provider Directory
Tax ID family
Lebanon Family Dentistry LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1430 W Baddour Pkwy
Ste B
Lebanon, TN 37087
Phone (615) 444-0322

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1710115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1295593457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 W BADDOUR PKWY STE B",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872656",
            "telephone_number": "931-704-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 W BADDOUR PKWY STE B",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872656",
            "telephone_number": "931-704-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "DANIEL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "RICARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-830-2176",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.