Mid-Cumberland Endodontics

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

3913-170 Issued in TN

Legal business name

MID-CUMBERLAND ENDODONTICS

Practice address

1324 Trotwood Ave
Suite #2
Columbia, TN 38401-4750

Phone

(931) 388-5627

Fax

(931) 381-6797

NPI assigned

Jun 22, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Phillip Wayne Head, DDSCAGSNPI 1154312437

Title

Dentist

Phone

(931) 388-5627

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip Wayne Head Sr., DDS CAGS

  • Endodontics
  • Columbia, TN
  • NPI 1154312437
  NPD (past) Authorized official
• Thomas Brian Bozeman, DDS

  • Endodontics
  • Columbia, TN
  • NPI 1376638288
  NPD (past)

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1679955165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 TROTWOOD AVE",
            "address_2": "SUITE #2",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014750",
            "telephone_number": "931-388-5627",
            "fax_number": "931-381-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 TROTWOOD AVE",
            "address_2": "SUITE #2",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014750",
            "telephone_number": "931-388-5627",
            "fax_number": "931-381-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-CUMBERLAND ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "931-388-5627",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDSCAGS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TN",
            "license": "3913-170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Edward Merkel, MSN, APRN, FNP-C
• Mark H Messenger, MD
• Robert Charles Messersmith, MD
• Heather A Michalak, M.D.
• Heather Christine Michaud, B.S.
• Mid-South Family Therapy PLLC
• Mid-South Gastroenterology Assoc PC
• Mid-South Gastroenterology Assoc PC
• Mid-South Surgeons, PLLC
• Mid-South Surgeons, PLLC

• Endodontics in Columbia, TN
• Providers in Columbia, TN by specialty
• Endodontics in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.