BOTTS DENTAL SPA PC (NPI# 1508007717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508007717 |
| Entity Type | Organization |
| Organization Name | BOTTS DENTAL SPA PC |
| Practice Address |
1055 N. Houston Levee Rd. Suite 102 Cordova TN 38018-6689 |
| Practice Telephone | 9017372200 |
| Practice Fax Number | 9017372277 |
| Mailing Telephone | 9017372200 |
| Mailing Fax Number | 9017372277 |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-11-06 |
| Authorized Official Name | DR. JASON BRYCE BOTTS (PRESIDENT/OWNER) |
| Authorized Official Telephone | 9017372200 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | BB9917824 | Suppliers | |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DS0000008754 | TN | Ambulatory Health Care Facilities |
| Street Address |
1055 N. HOUSTON LEVEE RD. SUITE 102 |
| City | CORDOVA |
| State | TN |
| Zip Code | 38018-6689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264428 | Shaquia Janai Harris | Behavior Technician | 1079 N Houston Levee Road, Cordova, TN 38018 | 2020-10-29 |
| 1366041493 | Cynthia Brantley | Behavior Technician | 1079 N Houston Levee Rd, Cordova, TN 38018 | 2020-10-20 |
| 1558901736 | At Home Physical Rehabilitation Group, LLC | Physical Therapy Assistant | 856 Willow Tree Circle, Cordova, TN 38018 | 2020-01-15 |
| 1538703038 | Scott Eric Balogh | Psychiatry & Neurology | 65 Germantown Court, Suite 203, Cordova, TN 38018 | 2019-10-29 |
| 1851871305 | Joanna H Fussell | Behavioral Analyst | 8066 Walnut Run Suite 102, Cordova, TN 38018 | 2018-08-15 |
| 1841736097 | A Guardian Care Group | Home Health | 10164 Green Moss, Cordova, TN 38018 | 2017-01-12 |
| 1497127146 | Functional Independence, Inc. | Home Health | 270 German Oak Dr., Memphis, TN 38018 | 2015-10-21 |
| 1679984363 | Tiffany Masters Redfern | Obstetrics & Gynecology | 521 Riveredge Dr W, Cordova, TN 38018 | 2014-05-15 |
| 1295073427 | Mitchell Wyman Alvarez | Optometrist | 2075 N. Germantown Pkwy, Memphis, TN 38018 | 2013-01-23 |
| 1578827531 | Chiung Feng Hsu | Dentist | 831 Timber Creek Dr #1, Cordova, TN 38018 | 2012-06-25 |
| Find all providers in zip 38018 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557380 | Ironwood Dental | Clinic/Center | 2550 Madison St, Clarksville, TN 37043-3704 | 2020-10-29 |
| 1942828124 | Adkins Family Dentistry, Pllc | Clinic/Center | 600 Tusculum Blvd Ste 1, Greeneville, TN 37745-3954 | 2020-07-14 |
| 1720605520 | Nancy Laden, D.m.d., P.l.l.c. | Clinic/Center | 105 Se Parkway Ste 101, Franklin, TN 37064-3932 | 2020-06-29 |
| 1922627413 | Colonial Dental, Plc | Clinic/Center | 560 Colonial Rd Ste 100, Memphis, TN 38117-4033 | 2020-04-14 |
| 1841823234 | Randall Restorative Solutions, Pllc | Clinic/Center | 1373 Bridgeview Dr, Chattanooga, TN 37415-1468 | 2020-02-13 |
| 1841822301 | Treasure Island Pediatric Dentistry | Clinic/Center | 1900 Medical Center Parkway, 110, Murfreesboro, TN 37129 | 2020-02-12 |
| 1437780905 | Knoxville Dentistry Group Pllc | Clinic/Center | 1119 Kingston Pike, Knoxville, TN 37934 | 2020-02-03 |
| 1073155511 | Captains Way Dentistry | Clinic/Center | 3001 Knoxville Center Dr Ste 1100, Knoxville, TN 37924-5076 | 2019-10-16 |
| 1053961227 | Memphis Dentures and Implants Pllc | Clinic/Center | 8950 Us-64, Suite 108, Lakeland, TN 38002-4566 | 2019-09-18 |
| 1497307730 | Robert C Wilhite Jr Dds Pllc | Clinic/Center | 1300 Hatcher Ln Ste 1, Columbia, TN 38401-3554 | 2019-07-16 |
| Find all providers with the same taxonomy | ||||
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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.