Individual provider Active NPI

Dana Short Riley

  • General Practice Dentistry
  • Knoxville, TN
National Provider Identifier
1881190619
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10965 Issued in TN
Practice address
10509 Hardin Valley Rd
Knoxville, TN 37932-1502
Phone
(865) 693-5030
NPI assigned
Apr 2, 2018
Last updated
Jan 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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 10965 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

10509 Hardin Valley Rd
Knoxville, TN 37932-1502

Mailing address

10509 Hardin Valley Rd
Knoxville, TN 37932-1502
Phone (865) 693-5030

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018001718 TN Order and Referring Only - DentistPractitioner - Dentist 9133472228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10965TNMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryville Dental Care General Practice PastSince Dec 1, 2022 Accepting new patients
Austin Owen DDS, PLLC PastSince Feb 26, 2023 Accepting new patients

Organizations & group practices 2

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1881190619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10509 HARDIN VALLEY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321502",
            "telephone_number": "865-693-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10509 HARDIN VALLEY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321502",
            "telephone_number": "865-693-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "DANA",
        "middle_name": "SHORT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-02",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10965",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.