Advanced Dental Concepts PC
Organization Active NPI General Practice Dentistry · Knoxville, TN
NPI 1417033804 · NPPES record last updated Dec 13, 2011
Key facts
- NPI
- 1417033804
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS7270 (TN)
- Legal business name
- ADVANCED DENTAL CONCEPTS PC
- Practice address
- 6311 Kingston Pike
Suite 8-W
Knoxville, TN 37919-4906 - Phone
- (865) 584-7336
- Fax
- (865) 584-6208
- NPI assigned
- Oct 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Fredrico Albert Dixon III, DDS
- Title
- President
- Phone
- (865) 584-7336
National Provider Directory
Locations
6311 Kingston Pike
Ste 8W
Knoxville, TN 37919
Phone (865) 306-5995
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | DS7270 | TN | Yes |
Addresses
Primary practice location
6311 Kingston Pike
Suite 8-W
Knoxville, TN 37919-4906
Mailing address
6311 Kingston Pike
Suite 8-W
Knoxville, TN 37919-4906
Phone (865) 584-7336
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1525931 | Medicaid | TN | |
| 110001 | Other | TN | TN CARE LOCATION |
| 1508041526 | Other | TN | HYGENIST NPI # |
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All providers in Knoxville, TN · General Practice Dentistry in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.