NPIMap

Organization Active NPI

Andrew W. Moseley D.D.S.P.C.

  • Dental Clinic/Center
  • Clarksville, TN
National Provider Identifier
1639296437
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
3259 Issued in TN
Legal business name
ANDREW W. MOSELEY D.D.S.P.C.
Practice address
2063 Wilma Rudolph Blvd
Clarksville, TN 37040-6621
Phone
(931) 552-1302
Fax
(931) 552-4755
NPI assigned
Mar 25, 2007
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
Dr. Andrew W. Moseley, D.D.S.NPI 1336225176
Title
President
Phone
(931) 552-1302

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
Dental Clinic/Center 261QD0000X 3259 TN Primary

Addresses

Primary practice location

2063 Wilma Rudolph Blvd
Clarksville, TN 37040-6621

Mailing address

PO Box 30039
Clarksville, TN 37040-0001

National Provider Directory

National Provider Directory

Locations

2063 Wilma Rudolph Blvd
Clarksville, TN 37040
Phone (931) 552-1302

Practitioners & affiliated clinicians

Practitioners 1

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": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639296437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30039",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370400001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2063 WILMA RUDOLPH BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406621",
            "telephone_number": "931-552-1302",
            "fax_number": "931-552-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW W. MOSELEY D.D.S.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOSELEY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "931-552-1302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "3259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, 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.