DR. NATHAN DALE WILLIS (NPI# 1851372015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851372015 |
| Entity Type | Individual |
| Full Name | DR. NATHAN DALE WILLIS |
| Credential | D.D.S. |
| Practice Address |
401 Edgemont Ave Bristol TN 37620-2314 |
| Practice Telephone | 4899684422 |
| Practice Fax Number | 4239683477 |
| Mailing Telephone | 4899684422 |
| Mailing Fax Number | 4239683477 |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS0000005035 | TN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | DORAL DENTAL | 0016417 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841824042 | Nathan Willis | Behavior Technician | 11905 Bowman Dr Ste 507, Fredericksburg, VA 22408-7344 | 2020-02-26 |
| Street Address |
401 EDGEMONT AVE |
| City | BRISTOL |
| State | TN |
| Zip Code | 37620-2314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114949294 | Brandon Scott Roller | Dentist | 401 Edgemont Ave, Bristol, TN 37620-2314 | 2006-07-24 |
| 1346225117 | Ronnie W Guest | Dentist | 401 Edgemont Ave, Bristol, TN 37620-2314 | 2005-12-14 |
| 1376528273 | William Chris Shipley | Dentist | 401 Edgemont Ave, Bristol, TN 37620-2314 | 2005-12-13 |
| 1750364337 | Frank M Geisenhaver | Dentist | 401 Edgemont Ave, Bristol, TN 37620-2314 | 2005-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
| 1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
| 1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
| 1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
| 1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
| 1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
| 1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
| 1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
| 1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
| 1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
| Find all providers in zip 37620 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881163822 | Signature Smile Dental LLC | Dentist | 1212 Veterans Hwy Ste A1, Bristol, PA 19007-2512 | 2018-11-20 |
| 1346757143 | Dental Associates of East Tennessee Pllc | Dentist | 1401 Volunteer Pkwy Ste 3, Bristol, TN 37620-6051 | 2018-01-03 |
| 1396297792 | Aaa Dental LLC | Dentist | 529 Farmington Ave, Bristol, CT 06010-3931 | 2016-11-01 |
| 1346608494 | Gentlecare Dental, LLC | Dentist | 683 Farmington Ave, Store #23, Bristol, CT 06010-3974 | 2016-02-03 |
| 1528479581 | Smiles Dental | Dentist | 87 Central St, Bristol, CT 06010-7046 | 2014-05-13 |
| 1588074025 | Bristol Family Dental, PC | Dentist | 4 Morris Ave, Bristol, CT 06010-4448 | 2014-05-06 |
| 1215369574 | In Kyung Lee | Dentist | 1192 Farmington Ave., Bristol, CT 06010 | 2013-08-08 |
| 1225392855 | Christopher Carle, Dds, PC | Dentist | 1401 Volunteer Pkwy, Bristol, TN 37620-6051 | 2012-06-28 |
| 1457622136 | Vsmiledental Vaishali Suchak LLC | Dentist | 603 Veterans Hwy, Bristol, PA 19007-2504 | 2012-01-26 |
| 1932435476 | Joseph Soliman | Dentist | 1212 Veterans Hwy, A1, Bristol, PA 19007-2512 | 2009-10-18 |
| Find all providers in BRISTOL | ||||
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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.