NPIMap

Organization Active NPI

Tennessee Dental Professionals, PC

  • General Practice Dentistry
  • Cookeville, TN
National Provider Identifier
1376009977
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TENNESSEE DENTAL PROFESSIONALS, PC
Practice address
121 S Washington Ave
Cookeville, TN 38501-3547
Phone
(931) 400-5360
NPI assigned
Feb 19, 2019
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

121 S Washington Ave
Cookeville, TN 38501-3547

Mailing address

121 S Washington Ave
Cookeville, TN 38501-3547

Other names 1

  • Johns Family & Implant Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of TN PC66 organizations share this tax ID, including this one
Part of
Heartland Dental Care of TN PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

121 S Washington Ave
Cookeville, TN 38501
Phone (412) 818-4727

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1376009977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 S WASHINGTON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S WASHINGTON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385013547",
            "telephone_number": "931-400-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johns Family & Implant Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.