Heart Leaf Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DS0000002831 Issued in TN

Legal business name

HEART LEAF DENTAL LLC

Practice address

5247 Old Harding Rd
Franklin, TN 37064-9409

Phone

(855) 259-9183

NPI assigned

Sep 16, 2015

Organization subpart

No

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

Authorized official

Name

Randall L Rudolph, DDS

Title

Owner

Phone

(855) 259-9183

Specialties & licenses 1

Addresses

Other names 1

• Special Care Dental Doing business as

Locations

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442361600000",
    "number": "1326417635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432404",
            "telephone_number": "855-259-9183",
            "fax_number": "502-254-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5247 OLD HARDING RD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370649409",
            "telephone_number": "855-259-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART LEAF DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2015-09-16",
        "status": "A",
        "authorized_official_last_name": "RUDOLPH",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-259-9183",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS0000002831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Special Care Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Franklin, TN
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; 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.