Mitchell Scott Tatum, D.D.S,

Primary specialty

DentistTaxonomy code 122300000X

License

DS 7129 Issued in TN

Practice address

201 S 3Rd St
Smithville, TN 37166-1712

Phone

(615) 597-4798

Fax

(615) 597-3171

NPI assigned

Sep 17, 2006

Last updated

Oct 22, 2020By the provider in NPPES

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

Other identifiers 1

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

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.

• Dekalb Dental Center PLLC

  • General Practice Dentistry
  • Smithville, TN
  • NPI 1700452026
  Authorized official Same address or phone
• Dekalb Sleep Solutions LLC

  • Durable Medical Equipment & Medical Supplies
  • Smithville, TN
  • NPI 1982204186
  NPD

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1831296425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 3RD ST",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371661712",
            "telephone_number": "615-597-4798",
            "fax_number": "615-597-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 3RD ST",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "371661712",
            "telephone_number": "615-597-4798",
            "fax_number": "615-597-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "MITCHELL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS 7129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3142596",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Beth Stephens, PHARM D
• Sumner Regional EMS LLC (Dekalb EMS)
• Suncrest Companion Services, LLC (SunCrest Companion Services of Smithville)
• Suncrest Healthcare of East Tennessee, LLC (Beacon Home Health)
• Prashanth Swamy, M.D.
• Tennessee Bone & Joint Clinic, PC
• Tennessee Oncology Pharmacy Dispensing
• Jessica Ingram Terrell, NP-C
• The Webb House Retirement Center, Inc
• Timothy D Tobitt, DPH, FNP-C, CEO

• Dentist in Smithville, TN
• Providers in Smithville, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.