NPIMap

Organization Active NPI

Foothills Pediatric Dentristry, P.C.

  • Pediatric Dentistry
  • Maryville, TN
National Provider Identifier
1629029657
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7965 Issued in TN
Legal business name
FOOTHILLS PEDIATRIC DENTRISTRY, P.C.
Practice address
121 Parliament Dr
Maryville, TN 37804-6210
Phone
(865) 977-8700
Fax
(865) 977-5464
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Garry Drew Osborn, D.D.S.NPI 1689626467
Title
Owner/Dentisit
Phone
(865) 977-8700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 7965 TN Primary

Addresses

Primary practice location

121 Parliament Dr
Maryville, TN 37804-6210

Mailing address

121 Parliament Dr
Maryville, TN 37804-6210
Phone (865) 977-8700

National Provider Directory

National Provider Directory

Locations

121 Parliament Dr
Maryville, TN 37804
Phone (865) 977-8700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629029657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARLIAMENT DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378046210",
            "telephone_number": "865-977-8700",
            "fax_number": "865-977-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PARLIAMENT DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378046210",
            "telephone_number": "865-977-8700",
            "fax_number": "865-977-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS PEDIATRIC DENTRISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OSBORN",
        "authorized_official_first_name": "GARRY",
        "authorized_official_middle_name": "DREW",
        "authorized_official_title_or_position": "OWNER/DENTISIT",
        "authorized_official_telephone_number": "865-977-8700",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "7965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.