Individual provider Active NPI

Juan R Aponte, DDS

  • General Practice Dentistry
  • Crossville, TN
National Provider Identifier
1831291236
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0000011511 Issued in TN
Practice address
125 Brown Ave
Crossville, TN 38555-4795
Phone
(931) 484-7650
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3572 ME
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0000011511 TN Primary

Addresses

Primary practice location

125 Brown Ave
Crossville, TN 38555-4795

Mailing address

125 Brown Ave
Crossville, TN 38555-4795
Phone (931) 484-7650

Other identifiers 2

IdentifierTypeStateIssuer
133650000MedicaidME
294110099OtherMEMAINE CARE

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

LicenseStateTypeSpecialty
0000011511TNMDGeneral Practice Dentistry
3572MEMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Hill Family & Cosmetic Dentistry PC CurrentSince May 9, 2021 Accepting new patients
Blue Hill Family & Cosmetic Dentistry PA Past Accepting new patients
MDG Dental Ellsworth PA LLC PastSince Dec 6, 2020 Accepting new patients

Locations

125 Brown Ave
Crossville, TN 38555
Phone (931) 456-2728

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1831291236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BROWN AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554795",
            "telephone_number": "931-484-7650",
            "fax_number": "207-374-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BROWN AVE",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554795",
            "telephone_number": "931-484-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APONTE",
        "first_name": "JUAN",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "3572",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "0000011511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133650000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE CARE",
            "identifier": "294110099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.