NPIMap

Organization Active NPI

Professional Dental Alliance of Tennessee, PLLC

  • Pediatric Dentistry
  • Franklin, TN
National Provider Identifier
1669530291
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS4359 Issued in TN
Legal business name
PROFESSIONAL DENTAL ALLIANCE OF TENNESSEE, PLLC
Practice address
125 Cool Springs Blvd Ste 140
Franklin, TN 37067-6475
Phone
(615) 771-1111
Fax
(615) 771-5113
NPI assigned
Dec 5, 2006
Last updated
Aug 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Authorized official

Name
Sarah Alston
Title
Credentialing
Phone
(240) 605-6412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DS4359 TN Primary

Addresses

Primary practice location

125 Cool Springs Blvd Ste 140
Franklin, TN 37067-6475

Mailing address

125 Enterprise Dr Ste 200
Pittsburgh, PA 15275-1223
Phone (724) 901-1964

National Provider Directory

National Provider Directory
Tax ID family
Professional Dental Alliance of Tennessee PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4761 Andrew Jackson Pkwy
Hermitage, TN 37076
Phone (615) 885-3525

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1669530291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 ENTERPRISE DR STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152751223",
            "telephone_number": "724-901-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COOL SPRINGS BLVD STE 140",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676475",
            "telephone_number": "615-771-1111",
            "fax_number": "615-771-5113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DENTAL ALLIANCE OF TENNESSEE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "ALSTON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "240-605-6412"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "DS4359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.