EAST TENNESSEE PEDIATRIC DENTISTRY PLLC (NPI# 1609211267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609211267 |
| Entity Type | Organization |
| Organization Name | EAST TENNESSEE PEDIATRIC DENTISTRY PLLC |
| Practice Address |
1103 Callahan Dr Knoxville TN 37912-1310 |
| Practice Telephone | 8658590355 |
| Practice Fax Number | 8658590227 |
| Mailing Telephone | 8658590355 |
| Mailing Fax Number | 8658590227 |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2017-01-09 |
| Authorized Official Name | DR. JESSICA PHILLIPS (OWNER) |
| Authorized Official Telephone | 8658590355 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
9446 | TN | Dental Providers |
| Street Address |
1103 CALLAHAN DR |
| City | KNOXVILLE |
| State | TN |
| Zip Code | 37912-1310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881912376 | Jessica Megan Phillips | Dentist | 1103 Callahan Dr, Knoxville, TN 37912-1310 | 2010-05-10 |
| 1083029086 | Ashley Russell | Dentist | 1103 Callahan Dr, Knoxville, TN 37912-1310 | 2014-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265098388 | Emily Katherine Hayes | Nurse Practitioner | 6626 Old Central Avenue Pike, Knoxville, TN 37912 | 2019-05-14 |
| 1063891620 | Sondra Haley | Counselor | 4610 Central Avenue Pike, Knoxville, TN 37912 | 2015-05-28 |
| 1518373257 | Andrew Clark | Case Manager/Care Coordinator | 100 Barberry Dr, Knoxville, TN 37912 | 2014-07-02 |
| 1265876940 | Annette Elise Long | Counselor | 4303 Central Ave.pike, Knoxville, TN 37912 | 2013-04-24 |
| 1346510393 | Lisa Taylor | Social Worker | 5800 Central Avenue Pike, Knoxville, TN 37912 | 2012-01-09 |
| 1447437447 | David Wesley Dickey IIi | Dentist | 5317 Clinton Hwy, Knoxville, TN 37912 | 2008-01-22 |
| 1962683573 | Eyexcel, Pllc | Optometrist | 715 Callahan Dr., Knoxville, TN 37912 | 2007-11-26 |
| 1538384995 | Chamberlain Chiropractic Clinic Inc | Chiropractor | 4409 Central Ave Pk, Suite 102, Knoxville, TN 37912 | 2007-04-13 |
| 1336232834 | Wesley Bruce Mclaughlin | Chiropractor | 2330 Merchants Dr., Knoxville, TN 37912 | 2006-10-02 |
| 1972073815 | Pell Enterprises | Home Health | 4303 Central Avenue Pike, Kno, TN 37912 | 2018-12-04 |
| Find all providers in zip 37912 | ||||
| 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.