Active NPI
Matthew Robert Vaughan, DMD
- General Practice Dentistry
- Ardmore, TN
National Provider Identifier
1982152542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11239
- Practice address
- 27001 Main St
Ardmore, TN 38449-3183 - Phone
- (931) 427-8581
- Fax
- (931) 427-8588
- NPI assigned
- Sep 13, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6321 | AL | |
| General Practice Dentistry | 1223G0001X | 11239 | TN | Primary |
Addresses
Primary practice location
27001 Main St
Ardmore, TN 38449-3183
Mailing address
27001 Main St
Ardmore, TN 38449-3183
Phone (931) 427-8581
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 |
|---|---|---|---|
| 11239 | TN | MD | General Practice Dentistry |
| 6321 | AL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vaughan Family Dentistry, PC | General Practice | Current | Accepting new patients |
| Barrett Dental | General Practice | Past | Accepting new patients |
Locations
27001 Main St
Ardmore, TN 38449
Phone (931) 427-8581
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607990400000",
"number": "1982152542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27001 MAIN ST",
"city": "ARDMORE",
"state": "TN",
"postal_code": "384493183",
"telephone_number": "931-427-8581",
"fax_number": "931-427-8588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27001 MAIN ST",
"city": "ARDMORE",
"state": "TN",
"postal_code": "384493183",
"telephone_number": "931-427-8581",
"fax_number": "931-427-8588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHAN",
"first_name": "MATTHEW",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-13",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "6321",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "11239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.