Active NPI
Nadareh M Naseri, D.D.S.
- Pediatric Dentistry
- Knoxville, TN
National Provider Identifier
1629565494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 11896
- Practice address
- 1516 Coleman Rd Ste 201
Knoxville, TN 37909-3809 - Phone
- (865) 558-8857
- NPI assigned
- Apr 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 11896 | TN | Primary |
Addresses
Primary practice location
1516 Coleman Rd Ste 201
Knoxville, TN 37909-3809
Mailing address
1516 Coleman Rd Ste 201
Knoxville, TN 37909-3809
Phone (865) 558-8857
Other practice location 1
209 E Emory Rd Ste 101
Powell, TN 37849-4050
Phone (865) 512-9611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11896 | TN | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Dentistry PC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Knoxville, TN
- NPI 1437557378
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1629565494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 COLEMAN RD STE 201",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379093809",
"telephone_number": "865-558-8857",
"fax_number": "865-321-8376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 COLEMAN RD STE 201",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379093809",
"telephone_number": "865-558-8857"
}
],
"practiceLocations": [
{
"address_1": "209 E Emory Rd Ste 101",
"address_purpose": "LOCATION",
"city": "Powell",
"state": "TN",
"postal_code": "378494050",
"country_code": "US",
"telephone_number": "865-512-9611",
"fax_number": "865-321-8376",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NASERI",
"first_name": "NADAREH",
"middle_name": "M",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-17",
"last_updated": "2024-01-10",
"certification_date": "2022-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TN",
"license": "11896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.