Organization Active NPI

Pickering & Allen Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Knoxville, TN
National Provider Identifier
1659996320
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
PICKERING & ALLEN ORTHODONTICS
Practice address
4741 N Broadway St
Knoxville, TN 37918-1793
Phone
(865) 687-9412
Fax
(865) 688-0656
NPI assigned
Jun 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Terri A. Hancock
Title
Office Coordinator
Phone
(865) 687-9412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

4741 N Broadway St
Knoxville, TN 37918-1793

Mailing address

4741 N Broadway St Ste C
Knoxville, TN 37918-1793
Phone (865) 687-9412

Other practice location 1

120 Capital Dr Ste 104
Knoxville, TN 37922-3475
Phone (865) 687-9412

Other identifiers 2

IdentifierTypeStateIssuer
Q037787MedicaidTN
Q006553MedicaidTN

National Provider Directory

National Provider Directory

Locations

4741 N Broadway St
Ste C
Knoxville, TN 37918
Phone (865) 687-9412

120 Capital Dr
Ste 104
Knoxville, TN 37922
Phone (865) 357-7878

4741 N Broadway St
Knoxville, TN 37918
Phone (865) 687-1940

Practitioners & affiliated clinicians

Practitioners 2

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": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1659996320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 N BROADWAY ST STE C",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379181793",
            "telephone_number": "865-687-9412",
            "fax_number": "865-688-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 N BROADWAY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379181793",
            "telephone_number": "865-687-9412",
            "fax_number": "865-688-0656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Capital Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379223475",
            "country_code": "US",
            "telephone_number": "865-687-9412",
            "fax_number": "865-688-0656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PICKERING & ALLEN ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "865-687-9412"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q037787",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q006553",
            "state": "TN"
        }
    ],
    "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 Jun 9, 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.