Sango Smiles Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

8466 Issued in TN

Legal business name

SANGO SMILES PEDIATRIC DENTISTRY

Practice address

2622 Madison St Ste G
Clarksville, TN 37043-6555

Phone

(931) 919-4898

Fax

(931) 919-4892

NPI assigned

Oct 10, 2017

Last updated

Oct 10, 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

Dr. Crystal Rucker, DMDNPI 1962560631

Title

Owner

Phone

(615) 557-4442

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Crystal Gilreath Rucker, D.M.D.

  • Pediatric Dentistry
  • Clarksville, TN
  • NPI 1962560631
  NPD (past) Authorized official

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1538679097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7520 LORDS CHAPEL DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372117040",
            "telephone_number": "615-557-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 MADISON ST STE G",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436555",
            "telephone_number": "931-919-4898",
            "fax_number": "931-919-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANGO SMILES PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-557-4442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "8466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precious Quankeshell Sanders, RBT
• Johana Sandoval Solis, BCBA, LBA
• Giselle Sandoval
• Sango Hills Dental PLLC
• Sango Movement Lab LLC
• Sango Speech Therapy, LLC
• Morgan Santana, LCSW
• Pranav Reddy Santapuram, MD
• Sapphire Home Health Services LLC
• Rosary Mary Sarmiento

• Pediatric Dentistry in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.