NPIMap

Organization Active NPI

Premier Dental Center

  • General Practice Dentistry
  • Jackson, TN
National Provider Identifier
1902160450
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS7790 Issued in TN
Legal business name
PREMIER DENTAL CENTER
Practice address
2574 Christmasville CV
Suite G
Jackson, TN 38305-7011
Phone
(731) 300-3000
Fax
(731) 300-3031
NPI assigned
Jun 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Authorized official

Name
Joseph M. Leonard
Title
DDS
Phone
(731) 300-3000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DS3413 TN
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DS7790 TN Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DS8401 TN
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DS3682 TN

Addresses

Primary practice location

2574 Christmasville CV
Suite G
Jackson, TN 38305-7011

Mailing address

2574 Christmasville CV
Suite G
Jackson, TN 38305-7011
Phone (731) 300-3000

National Provider Directory

National Provider Directory
Tax ID family
Premier Dental Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2574 Christmasville Cv
Ste G
Jackson, TN 38305
Phone (731) 300-3000

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1902160450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2574 CHRISTMASVILLE CV",
            "address_2": "SUITE G",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057011",
            "telephone_number": "731-300-3000",
            "fax_number": "731-300-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2574 CHRISTMASVILLE CV",
            "address_2": "SUITE G",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383057011",
            "telephone_number": "731-300-3000",
            "fax_number": "731-300-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-29",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "731-300-3000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS3413",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS7790",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS8401",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS3682",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

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