NPIMap

Organization Active NPI

Brentwood Pediatric Dentistry, LLC

  • Dental Clinic/Center
  • Brentwood, TN
National Provider Identifier
1730481540
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DS8825 Issued in TN
Legal business name
BRENTWOOD PEDIATRIC DENTISTRY, LLC
Practice address
95 Seaboard LN
Suite 102
Brentwood, TN 37027-3031
Phone
(615) 377-3080
Fax
(615) 377-3088
NPI assigned
Nov 30, 2010
Last updated
Nov 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Dr. Ryan A Cregger, DDSNPI 1811158124
Title
DDS/Owner
Phone
(615) 377-3080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DS8825 TN Primary

Addresses

Primary practice location

95 Seaboard LN
Suite 102
Brentwood, TN 37027-3031

Mailing address

95 Seaboard LN
Suite 102
Brentwood, TN 37027-3031
Phone (615) 377-3080

Other identifiers 1

IdentifierTypeStateIssuer
1509457MedicaidTN

National Provider Directory

National Provider Directory
Tax ID family
Brentwood Pediatric Dentistry2 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

95 Seaboard Ln
Ste 102
Brentwood, TN 37027
Phone (615) 377-3080

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1730481540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 SEABOARD LN",
            "address_2": "SUITE 102",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273031",
            "telephone_number": "615-377-3080",
            "fax_number": "615-377-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 SEABOARD LN",
            "address_2": "SUITE 102",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273031",
            "telephone_number": "615-377-3080",
            "fax_number": "615-377-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "CREGGER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "615-377-3080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "DS8825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509457",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.