Individual provider Active NPI

Crystal Angelopoulos, D.M.D.

  • Pediatric Dentistry
  • Old Hickory, TN
National Provider Identifier
1982714788
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
12137 Issued in TN
Practice address
3808 Old Hickory Blvd
Old Hickory, TN 37138-2220
Phone
(615) 599-0007
NPI assigned
Aug 30, 2006
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 52708 CA
Pediatric Dentistry 1223P0221X 12137 TN Primary

Addresses

Primary practice location

3808 Old Hickory Blvd
Old Hickory, TN 37138-2220

Mailing address

3808 Old Hickory Blvd
Old Hickory, TN 37138-2220
Phone (615) 599-0007

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
52708CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Grin Doctors PLLC Pediatric Dentistry CurrentSince Sep 5, 2023 Accepting new patients
Hydo, Angelopoulos & Miller Dental Group Pediatric Dentistry Past Accepting new patients

Locations

3808 Old Hickory Blvd
Old Hickory, TN 37138
Phone (615) 599-0007

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1982714788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 OLD HICKORY BLVD",
            "city": "OLD HICKORY",
            "state": "TN",
            "postal_code": "371382220",
            "telephone_number": "615-599-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 OLD HICKORY BLVD",
            "city": "OLD HICKORY",
            "state": "TN",
            "postal_code": "371382220",
            "telephone_number": "615-599-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELOPOULOS",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "52708",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "12137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Hickory, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.