Active NPI
Theodore Francis Unland IV, D.M.D
- Dentist
- Hermitage, TN
National Provider Identifier
1396882486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8235
- Practice address
- 4757 Andrew Jackson Pkwy
Hermitage, TN 37076-1301 - Phone
- (615) 885-0181
- NPI assigned
- Jan 30, 2007
- Last updated
- Jan 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8235 | TN | Primary |
Addresses
Primary practice location
4757 Andrew Jackson Pkwy
Hermitage, TN 37076-1301
Mailing address
4757 Andrew Jackson Pkwy
Hermitage, TN 37076-1301
Phone (615) 885-0181
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160719000160 | TN | Order and Referring Only - Other (Non-Physician) | 9436442167 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8235 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199664000000",
"number": "1396882486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4757 ANDREW JACKSON PKWY",
"city": "HERMITAGE",
"state": "TN",
"postal_code": "370761301",
"telephone_number": "615-885-0181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4757 ANDREW JACKSON PKWY",
"city": "HERMITAGE",
"state": "TN",
"postal_code": "370761301",
"telephone_number": "615-885-0181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNLAND",
"first_name": "THEODORE",
"middle_name": "FRANCIS",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2008-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "8235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hermitage, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.