Individual provider Active NPI

Kyna Dublin, DDS

  • Dentist
  • Franklin, TN
National Provider Identifier
1396891768
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8188 Issued in TN
Practice address
1800 Galleria Blvd
Space 1360
Franklin, TN 37067-1605
Phone
(615) 771-8809
Fax
(615) 771-8805
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8188 TN Primary

Addresses

Primary practice location

1800 Galleria Blvd
Space 1360
Franklin, TN 37067-1605

Mailing address

1800 Galleria Blvd
Space 1360
Franklin, TN 37067-1605
Phone (615) 771-8809

Other identifiers 1

IdentifierTypeStateIssuer
60003142MedicaidTN

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
I20150713000038 TN Order and Referring Only - DentistPractitioner - Dentist 3678885126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8188TNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Dental Care of Tennessee, PC Past Accepting new patients

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396891768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GALLERIA BLVD",
            "address_2": "SPACE 1360",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671605",
            "telephone_number": "615-771-8809",
            "fax_number": "615-771-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 GALLERIA BLVD",
            "address_2": "SPACE 1360",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671605",
            "telephone_number": "615-771-8809",
            "fax_number": "615-771-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBLIN",
        "first_name": "KYNA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "8188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60003142",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

Verify at the official NPI Registry.