Active NPI
Madison Dolen, DDS
- Dentist
- Farragut, TN
National Provider Identifier
1871376905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12306
- Practice address
- 109 S Campbell Station Rd
Farragut, TN 37934-2845 - Phone
- (865) 622-8898
- NPI assigned
- Aug 14, 2023
- Last updated
- Aug 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12306 | TN | Primary |
Addresses
Primary practice location
109 S Campbell Station Rd
Farragut, TN 37934-2845
Mailing address
8711 Sunfish Way Apt 6306
Knoxville, TN 37923-6551
Phone (317) 728-6067
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231024001510 | TN | Order and Referring Only - Dentist | 3173979432 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12306 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Farragut Modern Dentistry, PC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1871376905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8711 SUNFISH WAY APT 6306",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379236551",
"telephone_number": "317-728-6067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 S CAMPBELL STATION RD",
"city": "FARRAGUT",
"state": "TN",
"postal_code": "379342845",
"telephone_number": "865-622-8898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLEN",
"first_name": "MADISON",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-14",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "12306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farragut, TN
- Madison P Cowan-Banker
- Karen Mathews Cross, OTA
- Tara G. Currie, R.PH.
- Austin Harris Delk, DPT
- Brittany Nicole Dickinson Wallace, DPT
- Heather D Duncan, MPT
- East Tennessee Children's Hospital Association, Inc (East Tennessee Children's Hospital Home Health Care DME)
- East Tennessee Children's Hospital Association, Inc. (East Tennessee Children's Hospital Home Health Infusion)
- Tyler Eisenhardt
- Welborn David England, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.