Organization Active NPI

Legacy Dental Family and Implant Dentistry

  • General Practice Dentistry
  • Crossville, TN
National Provider Identifier
1639019342
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LEGACY DENTAL FAMILY AND IMPLANT DENTISTRY
Practice address
582 Miller Ave Ste 102
Crossville, TN 38555-4481
Phone
(931) 291-9144
Fax
(931) 202-8676
NPI assigned
Mar 31, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Authorized official

Name
Tiffany Austin, RDH, OM
Title
RDH,Om
Phone
(931) 337-4447

Specialties & licenses 1

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

Addresses

Primary practice location

582 Miller Ave Ste 102
Crossville, TN 38555-4481

Mailing address

582 Miller Ave Ste 102
Crossville, TN 38555-4481
Phone (931) 291-9144

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1774915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1639019342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 MILLER AVE STE 102",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554481",
            "telephone_number": "931-291-9144",
            "fax_number": "931-202-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 MILLER AVE STE 102",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554481",
            "telephone_number": "931-291-9144",
            "fax_number": "931-202-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DENTAL FAMILY AND IMPLANT DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-31",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "RDH,OM",
        "authorized_official_telephone_number": "931-337-4447",
        "authorized_official_credential": "RDH, OM"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.