Smoky Mountain Pediatric Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

9031 Issued in TN

Legal business name

SMOKY MOUNTAIN PEDIATRIC DENTISTRY, PLLC

Practice address

550 Town Creek Rd E
Suite 101
Lenoir City, TN 37772-6289

Phone

(865) 766-4884

NPI assigned

Jan 29, 2014

Organization subpart

No

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

Authorized official

Name

Katherine Bodford Malone, DDSNPI 1992030969

Title

Pediatric Dentist

Phone

(865) 766-4884

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Bodford Malone, D.D.S

  • Pediatric Dentistry
  • Lenoir City, TN
  • NPI 1992030969
  NPD (past) Authorized official
• Adam Priestwood

  • Pediatric Dentistry
  • Lenoir City, TN
  • NPI 1922488832
  NPD (past)

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402099200000",
    "number": "1871916668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 TOWN CREEK RD E",
            "address_2": "SUITE 101",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377726289",
            "telephone_number": "865-766-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 TOWN CREEK RD E",
            "address_2": "SUITE 101",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377726289",
            "telephone_number": "865-766-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMOKY MOUNTAIN PEDIATRIC DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-06-07",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "BODFORD",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "865-766-4884",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "9031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522864",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tarah R Slusher, PHARM.D
• Emily Smith
• Alan N Smiy, MD
• Sullivan Daniel Smoak, MD
• Smoky Mountain Hearing Specialists 2 LLC
• Caitlin Smyth
• Maria Guadalupe Soto Tinoco
• David Bernard Staab, M.D.
• Gary Lee Stafford, M.D.
• Latonya Marie Stanley, LCSW

• Dental Clinic/Center in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Dental Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2014; 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.