NPIMap

Organization Active NPI

Tennessee Dental Professionals, PC

Doing business as Cane Ridge Dentist

  • General Practice Dentistry
  • Antioch, TN
National Provider Identifier
1578892915
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TENNESSEE DENTAL PROFESSIONALS, PC
Doing business as
Cane Ridge Dentist
Practice address
1315 Bell Road
Antioch, TN 37013-3077
Phone
(615) 717-0507
NPI assigned
Dec 14, 2009
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
All Cred
Title
Insurance/Credentialing
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1315 Bell Road
Antioch, TN 37013-3077

Mailing address

1315 Bell Road
Antioch, TN 37013-3077
Phone (615) 717-0507

Other names 1

  • Cane Ridge Dentist Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Dental Care of Tennessee PC66 organizations share this tax ID, including this one
Part of
Heartland Dental Care of Tennessee PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1315 Bell Rd
Antioch, TN 37013
Phone (615) 717-0507

Practitioners & affiliated clinicians

Practitioners 6

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": "1260748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1578892915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 BELL ROAD",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133077",
            "telephone_number": "615-717-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 BELL ROAD",
            "city": "ANTIOCH",
            "state": "TN",
            "postal_code": "370133077",
            "telephone_number": "615-717-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2009-12-14",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "CRED",
        "authorized_official_first_name": "ALL",
        "authorized_official_title_or_position": "INSURANCE/CREDENTIALING",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cane Ridge Dentist",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cane Ridge Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antioch, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.