Individual provider Active NPI

Troy L. Long III, D.D.S.

  • General Practice Dentistry
  • Lebanon, TN
National Provider Identifier
1912987538
Registry record updated Mar 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
005365 Issued in TN
Practice address
212 N Castle Heights Ave
Suite a
Lebanon, TN 37087-2740
Phone
(615) 444-2782
Fax
(615) 444-4354
NPI assigned
Jan 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 005365 TN Primary

Addresses

Primary practice location

212 N Castle Heights Ave
Suite a
Lebanon, TN 37087-2740

Mailing address

212 N Castle Heights Ave
Suite a
Lebanon, TN 37087-2740
Phone (615) 444-2782

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

LicenseStateTypeSpecialty
005365TNMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457568000000",
    "number": "1912987538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N CASTLE HEIGHTS AVE",
            "address_2": "SUITE A",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872740",
            "telephone_number": "615-444-2782",
            "fax_number": "615-444-4354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N CASTLE HEIGHTS AVE",
            "address_2": "SUITE A",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872740",
            "telephone_number": "615-444-2782",
            "fax_number": "615-444-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "TROY",
        "middle_name": "L.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2016-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "005365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; 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.