Individual provider Active NPI

Kristina Shuba

  • General Practice Dentistry
  • Franklin, TN
National Provider Identifier
1811458516
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11132 Issued in TN
Practice address
125 Cool Springs Blvd Ste 140
Franklin, TN 37067-6475
Phone
(615) 771-1111
NPI assigned
Mar 26, 2019
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11132 TN
General Practice Dentistry 1223G0001X 11132 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

125 Cool Springs Blvd Ste 140
Franklin, TN 37067-6475

Mailing address

125 Cool Springs Blvd Ste 140
Franklin, TN 37067-6475
Phone (615) 771-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190904001509 TN Order and Referring Only - DentistPractitioner - Dentist 0749519577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11132TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Wellness Dentistry Current Accepting new patients
Professional Dental Alliance of Tennessee, PLLC CurrentSince Aug 6, 2023 Accepting new patients
Professional Dental Alliance of Crossville, PLLC CurrentSince Sep 8, 2025 Accepting new patients

Locations

125 Cool Springs Blvd
Ste 140
Franklin, TN 37067
Phone (615) 771-1111

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1811458516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COOL SPRINGS BLVD STE 140",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676475",
            "telephone_number": "615-771-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COOL SPRINGS BLVD STE 140",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676475",
            "telephone_number": "615-771-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBA",
        "first_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11132",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11132",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

Verify at the official NPI Registry.