Charles Edward Daley III, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS0000007841 Issued in TN

Practice address

401 W Main St
Suite 104
Lebanon, TN 37087-3584

Phone

(615) 444-9611

Fax

(615) 444-9835

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831286376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W MAIN ST",
            "address_2": "SUITE 104",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873584",
            "telephone_number": "615-444-9611",
            "fax_number": "615-444-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W MAIN ST",
            "address_2": "SUITE 104",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370873584",
            "telephone_number": "615-444-9611",
            "fax_number": "615-444-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEY",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "DS0000007841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Rose Curcio
• Amanda Curtis, NURSE PRACTITIONER
• D & O Group LLC
• Misty L. Dailey, RN, FNP
• Janet Daily, APN
• Darryl Champion
• Hilary Daugherty
• Kaylee Nicole Davenport, OTR/L
• Richard Alan Davenport Sr., C.R.N.A., M.S.
• Christin Davis, PHARMD

• Periodontics in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Periodontics in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.