Project Dental Access, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

DS4867 Issued in TN

Legal business name

PROJECT DENTAL ACCESS, INC.

Practice address

9329 Middlebrook Pike
Knoxville, TN 37931-4704

Phone

(865) 333-1611

Fax

(800) 879-9969

NPI assigned

Dec 22, 2017

Last updated

Dec 22, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debra M Hall Fisher, BS, RDH, RDA

Title

Executive Director

Phone

(865) 333-1611

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513900800000",
    "number": "1467968701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31107",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379301107",
            "telephone_number": "865-333-1611",
            "fax_number": "800-879-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9329 MIDDLEBROOK PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314704",
            "telephone_number": "865-333-1611",
            "fax_number": "800-879-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT DENTAL ACCESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-22",
        "last_updated": "2017-12-22",
        "status": "A",
        "authorized_official_last_name": "HALL FISHER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "865-333-1611",
        "authorized_official_credential": "BS, RDH, RDA"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "DS",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS4867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.