NPIMap

Organization Active NPI

Brentwood Endodontics LLC

  • Endodontics
  • Brentwood, TN
National Provider Identifier
1386168607
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7113 Issued in TN
Legal business name
BRENTWOOD ENDODONTICS LLC
Practice address
5111 Maryland Way Suite 209
Brentwood, TN 37027
Phone
(615) 376-8865
Fax
(615) 373-7699
NPI assigned
Jul 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Tammy Howard
Title
Office Manager
Phone
(615) 376-8865

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223E0200X 7113 TN Primary

Addresses

Primary practice location

5111 Maryland Way Suite 209
Brentwood, TN 37027

Mailing address

5111 Maryland Way Ste 209
Brentwood, TN 37027-7513
Phone (615) 376-8865

Other names 2

  • Brentwood Endodontics LLC Doing business as
  • Vince E. Hicks DDS Other name

National Provider Directory

National Provider Directory

Locations

5111 Maryland Way
Ste 209
Brentwood, TN 37027
Phone (615) 376-8865

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1386168607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 MARYLAND WAY STE 209",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277513",
            "telephone_number": "615-376-8865",
            "fax_number": "615-373-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 MARYLAND WAY SUITE 209",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-376-8865",
            "fax_number": "615-373-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "615-376-8865",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TN",
            "license": "7113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Endodontics LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brentwood Endodontics LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vince E. Hicks DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.