Kaitlyn Glasscock, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10773 Issued in TN

Practice address

160 Movie Row
Smyrna, TN 37167-6532

Phone

(615) 930-9606

NPI assigned

Jun 13, 2018

Last updated

Jun 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Glasscock Family Dentistry of Nashville

  • Dental Clinic/Center
  • Nashville, TN
  • NPI 1811651623
  NPD Authorized official
• Smyrna Modern Dentistry, PC

  dba Smyrna Modern Dentistry

  • Dentist
  • Smyrna, TN
  • NPI 1669840211
  NPD (past)

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1861985848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ARDMORE PL",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370648647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MOVIE ROW",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676532",
            "telephone_number": "615-930-9606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSCOCK",
        "first_name": "KAITLYN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quantasia Gilliam, MS, CCC-SLP
• Stephanie Giron
• Khaisha Verdelle Gist, M.D.
• Joshua Gitsham
• Ebony Gladden
• Renee L. Glenn, M.D.
• Miller Goan
• Diamond Goins
• Christopher M. Golden, M.D.
• Tavia Isaura Gonzalez Pena, MD, MPH

• General Practice Dentistry in Smyrna, TN
• Providers in Smyrna, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.