Active NPI
Spencer Garrett Warren, DDS
- Pediatric Dentistry
- Madison, TN
National Provider Identifier
1811526239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 11809
- Practice address
- 500 Lentz Dr Ste 40
Madison, TN 37115 - Phone
- (615) 868-9057
- NPI assigned
- Apr 7, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 11809 | TN | Primary |
| Pediatric Dentistry | 1223P0221X | 30.026384 | OH | |
| Dentist | 122300000X | 30.026384 | OH |
Addresses
Primary practice location
500 Lentz Dr Ste 40
Madison, TN 37115
Mailing address
1327 Cardinal Ave
Nashville, TN 37216-2310
Phone (931) 808-4592
Other practice location 1
380 Butterfly Gardens Dr
Columbus, OH 43215-7508
Phone (614) 722-5650
Other practice location 2
700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0439284 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.026384 | OH | MD | Dentist |
| 11809 | TN | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733184000000",
"number": "1811526239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1327 CARDINAL AVE",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372162310",
"telephone_number": "931-808-4592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 LENTZ DR STE 40",
"city": "MADISON",
"state": "TN",
"postal_code": "37115",
"telephone_number": "615-868-9057"
}
],
"practiceLocations": [
{
"address_1": "380 Butterfly Gardens Dr",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432157508",
"country_code": "US",
"telephone_number": "614-722-5650",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "700 Childrens Dr",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432052664",
"country_code": "US",
"telephone_number": "614-722-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WARREN",
"first_name": "SPENCER",
"middle_name": "GARRETT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-07",
"last_updated": "2024-12-03",
"certification_date": "2024-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TN",
"license": "11809",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OH",
"license": "30.026384",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.026384",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0439284",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.