NPIMap

Organization Active NPI

Elite Dental Care Eads

  • Dental Clinic/Center
  • Eads, TN
National Provider Identifier
1609454867
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ELITE DENTAL CARE EADS
Practice address
3159 Highway 64 Ste 100
Eads, TN 38028-3322
Phone
(901) 465-2382
NPI assigned
Mar 30, 2021
Last updated
Mar 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Clint Buchanan, DDS
Title
Owner
Phone
(731) 855-1053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3159 Highway 64 Ste 100
Eads, TN 38028-3322

Mailing address

2066 US Highway 45 Byp S
Trenton, TN 38382-3507
Phone (731) 855-1053

National Provider Directory

National Provider Directory

Locations

3159 Highway 64
Ste 100
Eads, TN 38028
Phone (901) 465-2382

Practitioners & affiliated clinicians

Practitioners 5

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": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1609454867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 US HIGHWAY 45 BYP S",
            "city": "TRENTON",
            "state": "TN",
            "postal_code": "383823507",
            "telephone_number": "731-855-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3159 HIGHWAY 64 STE 100",
            "city": "EADS",
            "state": "TN",
            "postal_code": "380283322",
            "telephone_number": "901-465-2382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DENTAL CARE EADS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "BUCHANAN",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-855-1053",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eads, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.