Active NPI
Jaclyn Talia Nutting, D.D.S.
- General Practice Dentistry
- Knoxville, TN
National Provider Identifier
1346477056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9028
- Practice address
- 6025 Brookvale LN
Suite 110
Knoxville, TN 37919-4031 - Phone
- (865) 588-5761
- NPI assigned
- Jun 19, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9028 | TN | Primary |
Addresses
Primary practice location
6025 Brookvale LN
Suite 110
Knoxville, TN 37919-4031
Mailing address
6025 Brookvale LN
Suite 110
Knoxville, TN 37919-4031
Phone (865) 300-3149
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9028 | TN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355875200000",
"number": "1346477056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6025 BROOKVALE LN",
"address_2": "SUITE 110",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379194031",
"telephone_number": "865-300-3149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6025 BROOKVALE LN",
"address_2": "SUITE 110",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379194031",
"telephone_number": "865-588-5761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUTTING",
"first_name": "JACLYN",
"middle_name": "TALIA",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-19",
"last_updated": "2012-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "9028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.