NPIMap

Organization Active NPI

Magnolia Dental Center of Cleveland, LLC

  • Dental Clinic/Center
  • Cleveland, TN
National Provider Identifier
1366284341
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
MAGNOLIA DENTAL CENTER OF CLEVELAND, LLC
Practice address
2190 Chambliss Ave NW
Cleveland, TN 37311-3839
Phone
(423) 476-3307
NPI assigned
Jun 10, 2024
Last updated
Jun 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Seth Weiler, DDSNPI 1396422820
Title
Owner
Phone
(770) 284-1395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

2190 Chambliss Ave NW
Cleveland, TN 37311-3839

Mailing address

1212 Dodds Ave
Chattanooga, TN 37404-4754
Phone (423) 206-9641

National Provider Directory

National Provider Directory

Locations

1212 Dodds Ave
Chattanooga, TN 37404
Phone (423) 206-9641

2190 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 476-3307

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1366284341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 DODDS AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374044754",
            "telephone_number": "423-206-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 CHAMBLISS AVE NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113839",
            "telephone_number": "423-476-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA DENTAL CENTER OF CLEVELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "WEILER",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-284-1395",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.