The Smile Spa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7481 Issued in TN

Legal business name

THE SMILE SPA

Practice address

8110 Cordova Rd
Suite 125
Cordova, TN 38016-0520

Phone

(901) 755-0001

Fax

(901) 755-9679

NPI assigned

Jul 6, 2011

Organization subpart

No

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

Authorized official

Name

Andrea M Henry, DDSNPI 1932284999

Title

Doctor

Phone

(901) 755-0001

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea Henry, DDS

  • General Practice Dentistry
  • Bartlett, TN
  • NPI 1932284999
  NPD (past) Authorized official

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1487941860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 CORDOVA RD",
            "address_2": "SUITE 125",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160520",
            "telephone_number": "901-755-0001",
            "fax_number": "901-755-9679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 CORDOVA RD",
            "address_2": "SUITE 125",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380160520",
            "telephone_number": "901-755-0001",
            "fax_number": "901-755-9679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SMILE SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "901-755-0001",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520260",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mary Elizabeth Thigpen
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• John Daniel Thomas Jr., DDS

• General Practice Dentistry in Cordova, TN
• Providers in Cordova, 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 Jul 6, 2011; 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.