Restorative Dental Associates PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RESTORATIVE DENTAL ASSOCIATES PLLC

Practice address

237 Dunbar Cave Rd Ste a
Clarksville, TN 37043-8852

Phone

(931) 648-0604

Fax

(931) 648-0605

NPI assigned

Mar 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth G Sandberg, D.D.S.

Title

General Dentist

Phone

(931) 648-0604

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1740589787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 DUNBAR CAVE RD STE A",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438852",
            "telephone_number": "931-648-0604",
            "fax_number": "931-648-0605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 DUNBAR CAVE RD STE A",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438852",
            "telephone_number": "931-648-0604",
            "fax_number": "931-648-0605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE DENTAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "SANDBERG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "931-648-0604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Dental Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.