NPIMap

Organization Active NPI

Periodontal & Implant Associates of Middle Tennessee, PLLC

  • Periodontics
  • Hendersonville, TN
National Provider Identifier
1689213902
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
PERIODONTAL & IMPLANT ASSOCIATES OF MIDDLE TENNESSEE, PLLC
Practice address
100 Springhouse Court
Ste. 220
Hendersonville, TN 37075-1610
Phone
(615) 264-6404
Fax
(615) 264-0689
NPI assigned
Jan 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Authorized official

Name
Dr. Robert P Pulliam, DMD, MSNPI 1518064401
Title
Periodontist/Owner
Phone
(615) 264-6404

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
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

100 Springhouse Court
Ste. 220
Hendersonville, TN 37075-1610

Mailing address

100 Springhouse Court
Ste. 220
Hendersonville, TN 37075-1610
Phone (615) 264-6404

National Provider Directory

National Provider Directory
Tax ID family
Periodontal Implant Associates of Middle Tennessee PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

100 Springhouse Ct
Ste 220
Hendersonville, TN 37075
Phone (615) 264-6404

Practitioners & affiliated clinicians

Practitioners 3

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": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1689213902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SPRINGHOUSE COURT",
            "address_2": "STE. 220",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370751610",
            "telephone_number": "615-264-6404",
            "fax_number": "615-264-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPRINGHOUSE COURT",
            "address_2": "STE. 220",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370751610",
            "telephone_number": "615-264-6404",
            "fax_number": "615-264-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL & IMPLANT ASSOCIATES OF MIDDLE TENNESSEE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "PULLIAM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PERIODONTIST/OWNER",
        "authorized_official_telephone_number": "615-264-6404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.