Perfect Smiles Dental Center

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

8170TN Issued in TN

Legal business name

PERFECT SMILES DENTAL CENTER

Practice address

1210 Hazelwood Dr
Suite a
Smyrna, TN 37167-3964

Phone

(615) 459-0566

Fax

(615) 459-0568

NPI assigned

Jul 6, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Tiye Dunlap

Title

Office Manager

Phone

(615) 459-0566

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1396032777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 HAZELWOOD DR",
            "address_2": "SUITE A",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371673964",
            "telephone_number": "615-459-0566",
            "fax_number": "615-459-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 HAZELWOOD DR",
            "address_2": "SUITE A",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371673964",
            "telephone_number": "615-459-0566",
            "fax_number": "615-459-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFECT SMILES DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "TIYE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "615-459-0566",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "TN",
            "license": "8170TN",
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TN",
            "license": "8170TN",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5442227",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Pendergrass, D.C.
• Mark Jacob Pendergrass, D.C.
• Renee Penner
• Kala Jo Pennington, MS CCCSLP
• Matthew Penny
• Matthew Lane Perkins, MD
• Jacqueline A Peters, NP
• Pharmacy Network Services
• Emya Phelps
• Heather Phillips, MD

• Preferred Provider Organization in Smyrna, TN
• Providers in Smyrna, TN by specialty
• Preferred Provider Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; 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.