Kimberly Susanna Dantzler, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10632 Issued in TN

Practice address

639 Lafayette St
Nashville, TN 37203-4226

Phone

(615) 227-3000

NPI assigned

Apr 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kimberly Susanna Tavares Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdantzler@direct.neighborhoodhealthtn.nextgenshare.com

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.

• United Neighborhood Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Nashville, TN
  • NPI 1750723029
  Medicare reassignment NPD
• United Neighborhood Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Nashville, TN
  • NPI 1942482062
  NPD
• United Neighborhood Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Gallatin, TN
  • NPI 1396510228
  NPD

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1437504529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1744 UMBRIA DRIVE",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-979-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 LAFAYETTE ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372034226",
            "telephone_number": "615-227-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZLER",
        "first_name": "KIMBERLY",
        "middle_name": "SUSANNA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-26",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "TAVARES",
            "middle_name": "SUSANNA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Danny Blaine Leeds, D.D.S. Dentistry, P.C
• Brandi L Dansby, RPH
• John Paul Dansby Jr.
• Ashley Dantzler
• David Mitchell Dantzler Jr., MD
• Camille Dao, PHARMD
• Michael M Dao, M.D.
• Jacquelin Darby, PSYD
• Pamela Darby, CSA
• Richard Ryan Durham Darby III, M.D.

• General Practice Dentistry in Nashville, TN
• Providers in Nashville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.

Verify at the official NPI Registry.