Active NPI
Deidra Harrison-McClain
- Dentist
- Goodlettsville, TN
National Provider Identifier
1922414606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10043
- Practice address
- 3050 Business Park Cir Ste 100
Goodlettsville, TN 37072-3659 - Phone
- (615) 859-0188
- NPI assigned
- Jul 2, 2014
- Last updated
- Nov 21, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10043 | TN | Primary |
Addresses
Primary practice location
3050 Business Park Cir Ste 100
Goodlettsville, TN 37072-3659
Mailing address
11726 Chapel Glen LN
Knoxville, TN 37934-1769
Phone (615) 417-5265
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 |
|---|---|---|---|
| 10043 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goodlettsville Dental Care, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Goodlettsville, TN
- NPI 1780172072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542758400000",
"number": "1922414606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11726 CHAPEL GLEN LN",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379341769",
"telephone_number": "615-417-5265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3050 BUSINESS PARK CIR STE 100",
"city": "GOODLETTSVILLE",
"state": "TN",
"postal_code": "370723659",
"telephone_number": "615-859-0188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON-MCCLAIN",
"first_name": "DEIDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-02",
"last_updated": "2018-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "10043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodlettsville, TN
- Emily Elizabeth Hansford, DNP, APRN, FNP-C
- Amer Haque, M.D.
- Stephanie Kaye Harding, D.D.S.
- Preston Lewis Harris Jr., DDS
- Sandra Gail Harris, DDS
- Sandra Vivian Harshaw, CNT/ PHLEBOTOMY
- Hart to Heart Medical (Hart Medical Clinic)
- Nancy Borja Hart, PHARM. D.
- Wanda J Hart
- Belinda Hancock Hatcher, FNP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.