Individual provider Active NPI

Amber Lynne Pearce, DMD

  • General Practice Dentistry
  • Elizabethton, TN
National Provider Identifier
1376151506
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11320 Issued in TN
Practice address
208 Parkway Blvd
Elizabethton, TN 37643-2845
Phone
(423) 543-5200
NPI assigned
Jul 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11320 TN Primary

Addresses

Primary practice location

208 Parkway Blvd
Elizabethton, TN 37643-2845

Mailing address

800 W Watauga Ave Apt 5
Johnson City, TN 37604-6476
Phone (423) 544-4286

Other names 1

  • Mrs. Amber Lynne Pearce Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201030002013 TN Order and Referring Only - DentistPractitioner - Dentist 8325458433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11320TNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Dentistry CurrentSince Jul 24, 2022 Accepting new patients

Locations

208 Parkway Blvd
Elizabethton, TN 37643
Phone (423) 543-5200

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1376151506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W WATAUGA AVE APT 5",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046476",
            "telephone_number": "423-544-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PARKWAY BLVD",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432845",
            "telephone_number": "423-543-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARCE",
        "first_name": "AMBER",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "PEARCE",
            "middle_name": "LYNNE",
            "prefix": "MRS.",
            "credential": "DMD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elizabethton, TN

Sources for this page

Verify at the official NPI Registry.