Dentistry and Fastbraces PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4679 Issued in TN

Legal business name

DENTISTRY AND FASTBRACES PC

Practice address

107 New Brick Church Pike
Suite C
Goodlettsville, TN 37072-1545

Phone

(615) 851-4744

NPI assigned

Oct 15, 2005

Organization subpart

No

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

Authorized official

Name

Dr. S Adele Doherty, DDS MPHNPI 1003077108

Title

Ceo President

Phone

(615) 851-4744

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.

• S Adele Doherty

  • Dentist
  • Goodlettsville, TN
  • NPI 1003077108
  NPD (past) Authorized official

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

{
    "created_epoch": "1129334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423699200000",
    "number": "1528057254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 NEW BRICK CHURCH PIKE",
            "address_2": "SUITE C",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721545",
            "telephone_number": "615-851-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NEW BRICK CHURCH PIKE",
            "address_2": "SUITE C",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370721545",
            "telephone_number": "615-851-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTRY AND FASTBRACES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-15",
        "last_updated": "2015-02-12",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "S",
        "authorized_official_middle_name": "ADELE",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "615-851-4744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MPH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "4679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005870",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Dayton, APRN
• Jessica S Deal, DOT
• Carrie Dedmon, PHARM D
• Luis Manuel Del Rio II, PTA
• Deme Corporation
• Victoria Dillehay, DDS
• Robin Disney, MS CCC-SLP
• S Adele Doherty
• Terrence J Doherty, M.D.
• Elliott Dombrosky

• Dental Clinic/Center in Goodlettsville, TN
• Providers in Goodlettsville, TN by specialty
• Dental Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.