Active NPI
Jessica Megan Phillips, DMD
- Pediatric Dentistry
- Knoxville, TN
National Provider Identifier
1881912376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 9446
- Practice address
- 1103 Callahan Dr
Knoxville, TN 37912-1310 - Phone
- (865) 859-0355
- NPI assigned
- May 10, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8904 | KY | |
| Pediatric Dentistry | 1223P0221X | 9446 | TN | Primary |
Addresses
Primary practice location
1103 Callahan Dr
Knoxville, TN 37912-1310
Mailing address
1103 Callahan Dr
Knoxville, TN 37912-1310
Phone (865) 859-0355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8904 | KY | MD | Dentist |
| 9446 | TN | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Tennessee Pediatric Dentistry at Oak Ridgepllc. | Pediatric Dentistry | Current | Accepting new patients |
| East Tennessee Pediatric Dentistry PLLC | Pediatric Dentistry | Past | 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 and National Provider Directory roles.
-
- Pediatric Dentistry
- Oak Ridge, TN
- NPI 1568952505
-
- Pediatric Dentistry
- Knoxville, TN
- NPI 1609211267
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1881912376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1103 CALLAHAN DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379121310",
"telephone_number": "865-859-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 CALLAHAN DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379121310",
"telephone_number": "865-859-0355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "JESSICA",
"middle_name": "MEGAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-10",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "8904",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "TN",
"license": "9446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.