Organization Active NPI

Dental Images PC

  • Dentist
  • Knoxville, TN
National Provider Identifier
1609549740
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL IMAGES PC
Practice address
1715 Downtown West Blvd
Knoxville, TN 37919-5413
Phone
(865) 531-1715
Fax
(865) 674-5498
NPI assigned
Jul 26, 2021
Last updated
Jul 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Rob Johnson
Title
Admin
Phone
(865) 531-1715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

1715 Downtown West Blvd
Knoxville, TN 37919-5413

Mailing address

1715 Downtown West Blvd
Knoxville, TN 37919-5413
Phone (865) 531-1715

Other identifiers 2

IdentifierTypeStateIssuer
1013447382OtherDENTAL
1588789549OtherDENTAL

Other names 1

  • Living Tree Dental Care Former legal business name

National Provider Directory

National Provider Directory

Locations

1715 Downtown West Blvd
Knoxville, TN 37919

Practitioners & affiliated clinicians

Practitioners 2

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": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1609549740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 DOWNTOWN WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195413",
            "telephone_number": "865-531-1715",
            "fax_number": "865-674-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 DOWNTOWN WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195413",
            "telephone_number": "865-531-1715",
            "fax_number": "865-674-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL IMAGES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROB",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "865-531-1715"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1013447382",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1588789549",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Tree Dental Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.