CUMBERLAND PEDIATRIC DENTISTRY AND ORTHODONTICS (NPI# 1154743110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154743110 |
| Entity Type | Organization |
| Organization Name | CUMBERLAND PEDIATRIC DENTISTRY AND ORTHODONTICS |
| Practice Address |
510 S Jefferson Ave Cookeville TN 38501-4010 |
| Mailing Address |
520 Highway 76 Ste 9 White House TN 37188-8212 |
| Practice Telephone | 9318541200 |
| Practice Fax Number | 6156727211 |
| Mailing Telephone | 9318541200 |
| Mailing Fax Number | 6156727211 |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2014-01-10 |
| Authorized Official Name | MR. BRYAN DAVID BRYNSIDE (OWNER/PROVIDER OF SERVICES) |
| Authorized Official Telephone | 6157587511 |
| Authorized Official Credential | MDM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
7907 | TN | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
8371 | TN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770837858 | Cumberland Pediatric Dentistry and Orthodontics | Clinic/Center | 520 Highway 76, Suite 8, White House, TN 37188-8212 | 2012-10-29 |
| Street Address |
510 S JEFFERSON AVE |
| City | COOKEVILLE |
| State | TN |
| Zip Code | 38501-4010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629519525 | Mallory Dawson | Dentist | 510 S Jefferson Ave, Cookeville, TN 38501-4010 | 2017-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596711 | Results-ast Jv, LLC | Physical Therapist | 627 James Campbell Blvd, South, Suite B, Columbia, TN 38501 | 2020-10-21 |
| 1376167080 | Melinda Jane Jetter | Registered Nurse | 320 North Willow Avenue, Cookeville, TN 38501 | 2020-05-29 |
| 1366950875 | Tara Beth Smith | Occupational Therapist | 315 N Washington Ave Ste 240, Cookeville, TN 38501 | 2018-01-18 |
| 1669990339 | Tonya Rachelle Perry | Counselor | 13 South Jefferson Ave, Cookeville, TN 38501 | 2017-09-01 |
| 1659896207 | Dustin Chase Rich | Physical Therapist | 105 S. Willow Ave, #100, Cookeville, TN 38501 | 2017-08-04 |
| 1487009668 | Holly Young | Physical Therapist | 315 North Washungton Ave., Suite 240, Cookeville, TN 38501 | 2016-04-26 |
| 1194190306 | Johnna Sprague | Nurse Practitioner | 620 S. Jefferson Ave, Suite 202, Cookeville, TN 38501 | 2015-12-14 |
| 1881099885 | Carlos Alberto Podesta | Internal Medicine | 238 W 4th St Ste 200, Cookeville, TN 38501 | 2014-11-03 |
| 1124445002 | Shashank Sarvepalli | Internal Medicine | 1 Medical Center Blvd Ste D, Cookeville, TN 38501 | 2014-03-27 |
| 1689095762 | Kendra Hicks | Licensed Practical Nurse | 701 County Services Drive, Cookeville, TN 38501 | 2013-12-17 |
| Find all providers in zip 38501 | ||||
| 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 |
|---|---|---|---|---|
| 1356876320 | Landon Sears | Dentist | 1265 Interstate Dr Ste 101, Cookeville, TN 38501-5198 | 2017-04-26 |
| 1215592340 | Cavity Commando's Dentistry for Kids Pllc | Dentist | 1265 Interstate Dr Ste 101, Cookeville, TN 38501-5198 | 2019-05-03 |
| 1548702244 | Hermitage Pediatric Dentistry, Pllc | Dentist | 1100 Neal St Ste B, Cookeville, TN 38501-0900 | 2016-11-11 |
| 1124283932 | Cookeville Regional Dental Inc | Dentist | 327 N Cedar Ave, Cookeville, TN 38501-2420 | 2008-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649879271 | Knoxville Pediatric Dentistry, Pllc | Dentist | 2944 Tazewell Pike Ste 1, Knoxville, TN 37918-1990 | 2020-10-24 |
| 1649886961 | Happy Teeth Pediatric Dentistry | Dentist | 129 Commons Dr, Martin, TN 38237-3882 | 2020-09-22 |
| 1144844879 | Dandridge Pediatric Dentistry | Dentist | 117 E Price Rd, Dandridge, TN 37725-4513 | 2020-05-28 |
| 1831711415 | Nashville Pediatric Dentistry | Dentist | 130 Seaboard Ln Ste A1, Franklin, TN 37067-8221 | 2020-05-18 |
| 1326685132 | East Nashville Pediatric Dentistry, Pllc | Dentist | 1077 E Trinity Ln Ste 104, Nashville, TN 37216-3067 | 2019-11-30 |
| 1285279836 | Lebanon Pediatric Dentistry, LLC | Dentist | 920 S Hartmann Dr, Lebanon, TN 37090-4018 | 2019-11-07 |
| 1225686157 | Brentwood Pediatric Dentistry Maryland Farms, Pllc | Dentist | 5109 Peter Taylor Park Dr Ste 100, Brentwood, TN 37027-7672 | 2019-09-04 |
| 1265087969 | Adventure Pediatric Dentistry, Pllc | Dentist | 6413 Lee Hwy Ste 119, Chattanooga, TN 37421-4861 | 2019-08-08 |
| 1942868336 | Juhn and Stark LLC | Dentist | 2333 Knob Creek Rd Ste 12, Johnson City, TN 37604-2007 | 2019-05-31 |
| 1093286304 | Wright Pediatric Dentistry | Dentist | 8202 Apison Pike, Ooltewah, TN 37363 | 2018-12-13 |
| Find all providers with the same taxonomy | ||||
| City | COOKEVILLE |
| Zip Code | 38501 |
Please comment or provide details below to improve the information on CUMBERLAND PEDIATRIC DENTISTRY AND ORTHODONTICS.
| 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.