Bluegrass Endodontics PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

8017 Issued in TN

Legal business name

BLUEGRASS ENDODONTICS PLLC

Practice address

100 Bluegrass Commons Blvd
Ste. 2180
Hendersonville, TN 37075-2732

Phone

(615) 824-7546

Fax

(615) 824-7547

NPI assigned

Feb 2, 2015

Organization subpart

No

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

Authorized official

Name

Miss Antonia Moran

Title

Practice Administrator

Phone

(615) 824-7546

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1710377577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BLUEGRASS COMMONS BLVD",
            "address_2": "STE. 2180",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752732",
            "telephone_number": "615-824-7546",
            "fax_number": "615-824-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BLUEGRASS COMMONS BLVD",
            "address_2": "STE. 2180",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752732",
            "telephone_number": "615-824-7546",
            "fax_number": "615-824-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS ENDODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "ANTONIA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "615-824-7546",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TN",
            "license": "8017",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TN",
            "license": "9429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.