NPIMap

Eric Basta, DDS

Individual provider Active NPI General Practice Dentistry · Gallatin, TN

NPI 1326570516 · NPPES record last updated Sep 6, 2022

Key facts

NPI
1326570516
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12005 (TN)
Practice address
1007 Nashville Pike Ste 100
Gallatin, TN 37066-3703
Phone
(615) 989-3400
NPI assigned
Mar 28, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

  • Emb Dentistry PC General Practice Dentistry · Gallatin, TN · NPI 1316644370
    NPD GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
019031209ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Emb Dentistry PC General Practice Current
since Feb 12, 2023		 Accepting new patients

Locations

1007 Nashville Pike
Ste 100
Gallatin, TN 37066
Phone (615) 442-3450

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019031209 IL
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 12005 TN Yes

Addresses

Primary practice location

1007 Nashville Pike Ste 100
Gallatin, TN 37066-3703

Mailing address

836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 975-1600

Other practice location 1

421 W Huron St Apt 805
Chicago, IL 60654-5998
Phone (585) 794-0036

Other providers in Gallatin, TN

All providers in Gallatin, TN · General Practice Dentistry in Tennessee

Sources for this page

Verify at the official NPI Registry.