NPIMap

Organization Active NPI

Tennessee Dental Professionals, PC

Doing business as Sophisticated Smiles

  • General Practice Dentistry
  • Johnson City, TN
National Provider Identifier
1619821162
Registry record updated Mar 24, 2026
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
Sophisticated Smiles
Practice address
189 Corporate Dr Ste 20
Johnson City, TN 37604-2385
Phone
(423) 928-8359
NPI assigned
Feb 23, 2026
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
TENNESSEE DENTAL PROFESSIONALS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

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

Addresses

Primary practice location

189 Corporate Dr Ste 20
Johnson City, TN 37604-2385

Mailing address

189 Corporate Dr Ste 20
Johnson City, TN 37604-2385
Phone (423) 928-8359

Other names 1

  • Sophisticated Smiles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tennessee Dental Professionals PC2 organizations share this tax ID, including this one
Part of
Tennessee Dental Professionals PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

189 Corporate Dr
Ste 20
Johnson City, TN 37604
Phone (423) 928-8359

NPI Registry JSON

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1619821162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 CORPORATE DR STE 20",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042385",
            "telephone_number": "423-928-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 CORPORATE DR STE 20",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042385",
            "telephone_number": "423-928-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE DENTAL PROFESSIONALS, PC",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "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": "Sophisticated Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.