NPIMap

Organization Active NPI

Providence Dental Care, Inc.

  • Dental Clinic/Center
  • Mount Juliet, TN
National Provider Identifier
1447352372
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DS0000004058 Issued in TN
Legal business name
PROVIDENCE DENTAL CARE, INC.
Practice address
684 N Mount Juliet Rd
Mount Juliet, TN 37122-3323
Phone
(615) 758-6800
Fax
(615) 758-8419
NPI assigned
Sep 1, 2006
Last updated
Jan 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Authorized official

Name
Dr. Larry Wayne Lafever, D.D.S
Title
President
Phone
(615) 758-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DS0000004058 TN Primary

Addresses

Primary practice location

684 N Mount Juliet Rd
Mount Juliet, TN 37122-3323

Mailing address

684 N Mount Juliet Rd
Mount Juliet, TN 37122-3323
Phone (615) 758-6800

Other names 1

  • LaFever Enterprises, Inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

684 N Mount Juliet Rd
Mt Juliet, TN 37122
Phone (615) 758-6800

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1447352372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 N MOUNT JULIET RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223323",
            "telephone_number": "615-758-6800",
            "fax_number": "615-758-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 N MOUNT JULIET RD",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223323",
            "telephone_number": "615-758-6800",
            "fax_number": "615-758-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE DENTAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "LAFEVER",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-758-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "DS0000004058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LaFever Enterprises, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.