Life Bridge Dental TN PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LIFE BRIDGE DENTAL TN PLLC

Practice address

970 Woodland St
Nashville, TN 37206-3722

Phone

(615) 601-5250

Fax

(615) 468-0325

NPI assigned

May 31, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth N Sullivan

Title

Director RCM

Phone

(615) 601-5250

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1356080352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 WOODLAND ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372063722",
            "telephone_number": "615-601-5250",
            "fax_number": "615-468-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 WOODLAND ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372063722",
            "telephone_number": "615-601-5250",
            "fax_number": "615-468-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE BRIDGE DENTAL TN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR RCM",
        "authorized_official_telephone_number": "615-601-5250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toddra Shavelle Liddell, APN
• Olga Kalitovna L Lieberman
• Nicole Liernur
• Alyssa Lietz
• Life Action Tennessee, Inc.
• Life Connect Health LLC
• Life Coordinated Inc
• Life Dental Tennessee PLLC
• Life Occupational Therapy Services, PLLC
• Life Recovery and Support

• General Practice Dentistry in Nashville, TN
• Providers in Nashville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.