BEARDEN PEDIATRIC DENTISTRY PLLC (NPI# 1083975536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083975536 |
| Entity Type | Organization |
| Organization Name | BEARDEN PEDIATRIC DENTISTRY PLLC |
| Practice Address |
601 Concord St Suite 102-104 Knoxville TN 37919-3307 |
| Practice Telephone | 8658519347 |
| Practice Fax Number | 8658517849 |
| Mailing Telephone | 8658519347 |
| Mailing Fax Number | 8658517849 |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2012-08-23 |
| Authorized Official Name | DR. ELIZABETH ANN EVANS (DDS) |
| Authorized Official Telephone | 8658519347 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 284300000X | Special Hospital | DS8702 | TN | Hospitals |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DS8702 | TN | Dental Providers |
| Street Address |
601 CONCORD ST SUITE 102-104 |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37919-3307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972557577 | Thomas P Hanaway | Psychologist | 601 Concord St, Ste.114, Knoxville, TN 37919-3307 | 2006-05-19 |
| 1376598029 | Vickie L Henderson | Social Worker | 601 Concord St, Ste.114, Knoxville, TN 37919-3307 | 2006-05-23 |
| 1770537375 | Robert G. Wahler | Psychologist | 601 Concord St, Ste.114, Knoxville, TN 37919-3307 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760099188 | Edp Biotech Corporation | Clinical Medical Laboratory | 6701 Baum Dr, Suite 110, Knoxville, TN 37919 | 2020-09-29 |
| 1649836248 | Jessica Diane Moody | Counselor | 6070 Lyons View Pike, Knoxville, TN 37919 | 2019-05-20 |
| 1952802571 | Maisie Drew Buckner | Physical Therapist | 301 S Gallaher View Rd Ste 105, Knoxville, TN 37919 | 2018-02-28 |
| 1992217400 | Jay S. Desvaux, D.d.s. | Dentist | 6311 Kingston Pike #27w, Knoxville, TN 37919 | 2017-10-25 |
| 1346768975 | Marilyn Lee | Occupational Therapist | 7014 Lawford Road, Knoxville, TN 37919 | 2017-09-04 |
| 1558884254 | Jck Holdings LLC | Family Medicine | 2270 Sutherland Avenue, Knoxville, TN 37919 | 2017-07-25 |
| 1295255503 | Emily M King | Marriage & Family Therapist | 131 N. Concord St, Knoxville, TN 37919 | 2017-06-27 |
| 1487105128 | Kathleen Rachelle Matteson | Physician Assistant | 2461 University Commons Way, Knoxville, TN 37919 | 2016-10-18 |
| 1689046161 | Meagan Lynn Ogunrinde | Registered Nurse | 265 Brockview Centre Way, Suite 400, Knoxville, TN 37919 | 2015-10-23 |
| 1720467624 | Chizoba Ngesina | Emergency Medicine | Teamhealth, 265 Brookview Centre Way Suite 400, Knoxville, TN 37919 | 2015-05-26 |
| Find all providers in zip 37919 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649879271 | Knoxville Pediatric Dentistry, Pllc | Dentist | 2944 Tazewell Pike Ste 1, Knoxville, TN 37918-1990 | 2020-10-24 |
| 1477755700 | Phillip B Powell | Dentist | 1516 Coleman Rd, Ste 208, Knoxville, TN 37909-3809 | 2007-05-31 |
| 1497825376 | Darryl Edward Phillips | Dentist | 323 Fox Rd, Suite 100, Knoxville, TN 37922-3383 | 2006-11-08 |
| 1538172713 | Mark Williams Crumpton | Dentist | 1516 Coleman Rd Ste 201, Knoxville, TN 37909-3809 | 2006-08-15 |
| 1033135546 | Jeffery B Arrowood | Dentist | 10261 Kingston Pike, Knoxville, TN 37922-3276 | 2006-07-15 |
| 1942284732 | Joseph Reed Townsend IIi | Dentist | 705 Gate Ln, Suite 101, Knoxville, TN 37909-3518 | 2005-12-05 |
| 1366430597 | Mike Douglas Mysinger | Dentist | 120 Capital Dr, Suite 101, Knoxville, TN 37922-3478 | 2005-10-12 |
| 1851756423 | Rocky Top Pediatric Dentistry, LLC | Dentist | 10261 Kingston Pike, Knoxville, TN 37922-3276 | 2015-12-23 |
| 1437557378 | Pediatric Dentistry PC | Dentist | 1516 Coleman Rd, Suite 201, Knoxville, TN 37909-3809 | 2014-12-09 |
| 1194147421 | James T. Deberry, Jr., Dds, Ms, PC | Dentist | 10261 Kingston Pike, Knoxville, TN 37922-3276 | 2014-01-06 |
| Find all providers in KNOXVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.