NPIMap

Organization Active NPI

Cornerstone Dental Associates Executive Park PLLC

  • Dentist
  • Knoxville, TN
National Provider Identifier
1649930728
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CORNERSTONE DENTAL ASSOCIATES EXECUTIVE PARK PLLC
Practice address
8925 Executive Park Dr
Knoxville, TN 37923-4708
Phone
(865) 693-8871
NPI assigned
Dec 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Authorized official

Name
Rebecca M Tucker
Title
Operations Manager
Phone
(865) 531-7117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

8925 Executive Park Dr
Knoxville, TN 37923-4708

Mailing address

8912 Town and Country Cir
Knoxville, TN 37923-4900
Phone (865) 531-7117

Other identifiers 1

IdentifierTypeStateIssuer
1205969524OtherTNNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rtucker@cornerstonedental.com Direct

National Provider Directory

National Provider Directory

Locations

8925 Executive Park Dr
Knoxville, TN 37923
Phone (865) 693-8871

8912 Town and Country Cir
Knoxville, TN 37923
Phone (865) 531-0300

Practitioners & affiliated clinicians

Practitioners 6

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": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640822400000",
    "number": "1649930728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8912 TOWN AND COUNTRY CIR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234900",
            "telephone_number": "865-531-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 EXECUTIVE PARK DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234708",
            "telephone_number": "865-693-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE DENTAL ASSOCIATES EXECUTIVE PARK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "865-531-7117"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205969524",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rtucker@cornerstonedental.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "8925 Executive Park Dr",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Dec 30, 2021; 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.