Diana Tina DO Mayo, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12055 Issued in TN

Practice address

3130 Tom Austin Hwy Ste B
Springfield, TN 37172-4579

Phone

(615) 382-9005

NPI assigned

Apr 29, 2015

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Flossophie PLLC

  • Pediatric Dentistry
  • Springfield, TN
  • NPI 1619790318
  NPD Authorized official
• Elgin Pediatric Dental PLLC

  dba Lone Star Pediatric Dental

  • Pediatric Dentistry
  • Elgin, TX
  • NPI 1235587700
  NPD (past)

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1760869622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 TOM AUSTIN HWY STE B",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 TOM AUSTIN HWY STE B",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371724579",
            "telephone_number": "615-382-9005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8716 Research Blvd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787586420",
            "country_code": "US",
            "telephone_number": "512-676-4444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250A Hwy 290 W",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "TX",
            "postal_code": "786213255",
            "country_code": "US",
            "telephone_number": "512-676-4444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 W 34th St",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787052008",
            "country_code": "US",
            "telephone_number": "512-676-4444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 Rock Springs Rd",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "TN",
            "postal_code": "371676141",
            "country_code": "US",
            "telephone_number": "615-220-6161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68-1845 Waikoloa Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Waikoloa",
            "state": "HI",
            "postal_code": "967385581",
            "country_code": "US",
            "telephone_number": "808-657-0844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYO",
        "first_name": "DIANA",
        "middle_name": "TINA DO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11677",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "HI",
            "license": "98",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "32478",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "HI",
            "license": "2874",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "12055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "830465",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Martin
• Ellissa Lauren Mason, PTA
• Jasmine Mason, PMHNP
• Sondra J. Matthews, RN
• Easton May, DPT
• Chelsy Marie McCarroll, FNP-BC
• Catherine McCarter
• Sterling McClain, DO
• James G McDowell Jr., M.D.
• Christina McElroy, DPT

• Pediatric Dentistry in Springfield, TN
• Providers in Springfield, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.