Lebanon Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LEBANON DENTAL, LLC

Practice address

102 Hartman Dr Ste H
Lebanon, TN 37087-1502

Phone

(615) 449-8800

Fax

(615) 453-6100

NPI assigned

Oct 15, 2018

Last updated

Oct 15, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Starlena Gannon

Title

Manager

Phone

(615) 440-8800

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bracy C Haynie, D.D.S.

  • Dentist
  • Lebanon, TN
  • NPI 1659533479
  NPD (past)

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539561600000",
    "number": "1891261020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HARTMAN DR STE H",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871502",
            "telephone_number": "615-449-8800",
            "fax_number": "615-453-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HARTMAN DR STE H",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370871502",
            "telephone_number": "615-449-8800",
            "fax_number": "615-453-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "STARLENA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "615-440-8800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Lawrence
• Judith J. Lea, RN
• Lebanon Center for Rehabilitation and Healing LLC
• Lebanon Dental Excellence
• Lebanon Dental Group
• Lebanon Digestive Disease
• Lebanon Emergency Physicians, PLLC
• Lebanon Endoscopy Center LLC (Lebanon Endoscopy Center)
• Lebanon Eye Associates (The Eye Center)
• Lebanon Eye Associates (The Eye Center)

• General Practice Dentistry in Lebanon, TN
• Providers in Lebanon, 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 Oct 15, 2018; 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.