Jay Scott Kuderewski, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

11371 Issued in TN

Practice address

5073 Main St Ste 240
Spring Hill, TN 37174-2738

Phone

(615) 302-4200

Fax

(615) 302-4201

NPI assigned

Aug 11, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Professional Dental Alliance of Crossville, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Franklin, TN
  • NPI 1720968639
  NPD
• Professional Dental Alliance of Tennessee, PLLC

  • Pediatric Dentistry
  • Franklin, TN
  • NPI 1669530291
  NPD

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1346851672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COOL SPRINGS BLVD STE 140",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676475",
            "telephone_number": "615-771-1111",
            "fax_number": "615-771-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5073 MAIN ST STE 240",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371742738",
            "telephone_number": "615-302-4200",
            "fax_number": "615-302-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDEREWSKI",
        "first_name": "JAY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Laurence Koster
• Dominika Katarzyna Kozakiewicz
• Julie Anne Krager, LMSW
• Kroger Limited Partnership I
• Anthony Krohn, DC
• Kristina Kobita Kuprienko, DMD
• Nathanael L Lafferty, M.D.
• Brandi Alexis Lafleur, PA
• Stephanie Lamas
• Noah Daniel Lanford

• Dentist in Spring Hill, TN
• Providers in Spring Hill, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.