SOUTHEASTERN DENTAL PLLC (NPI# 1386209849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1386209849 |
Entity Type | Organization |
Organization Name | SOUTHEASTERN DENTAL PLLC |
Practice Address |
117 Gallatin Pike N Madison TN 37115-3701 |
Practice Telephone | 6158686177 |
Mailing Telephone | 6158686177 |
Enumeration Date | 2019-05-09 |
Last Update Date | 2019-05-09 |
Authorized Official Name | VICKIE J METCALF (PRACTICE ADMINISTRATOR) |
Authorized Official Telephone | 6155683258 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
Street Address |
117 GALLATIN PIKE N |
City | MADISON |
State | TN |
Zip Code | 37115-3701 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164592226 | Darren G Foster | Dentist | 117 Gallatin Pike N, Madison, TN 37115-3701 | 2006-11-08 |
1801325667 | Sarah M Moore | Dentist | 117 Gallatin Pike N, Madison, TN 37115-3701 | 2017-06-06 |
1932652302 | Kinjal Vora | Dentist | 117 Gallatin Pike N, Madison, TN 37115-3701 | 2016-08-02 |
1225211287 | Floyd Ray Taylor | Dentist | 117 Gallatin Pike N, Madison, TN 37115-3701 | 2007-12-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023675212 | Kennedy Wayne Germany Jr. | Specialist/Technologist | 813 Seashell Cove, Madison, TN 37115 | 2019-05-22 |
1497211387 | Latasha Monique Williams | Social Worker | Patriot Place (va), 314 Williams Avenue, Ste. 100, Madison, TN 37115 | 2019-02-15 |
1659866481 | Amanda Elliott | Pharmacist | 109 Gallatin Rd, Madison, TN 37115 | 2018-06-25 |
1760938492 | Larry Cox | Case Manager/Care Coordinator | 620 S. Gallatin Pike, Madison, TN 37115 | 2016-09-01 |
1407202799 | National Vision, Inc. | Technician/Technologist | 1785 Gallatin Pike N, Madison, TN 37115 | 2016-05-05 |
1992190193 | Emily Tibbs | Case Manager/Care Coordinator | 620 Gallatin Pike, Madison, TN 37115 | 2015-04-03 |
1164829982 | Laura Boswell | Case Manager/Care Coordinator | 620 Gallatin Pike South, Madison, TN 37115 | 2014-11-21 |
1720498058 | Edward Andrew Roberts | Chiropractor | 1710 Gallatin Pike N, Madison, TN 37115 | 2014-05-08 |
1700296217 | Lamonia Merritt | Student in an Organized Health Care Education/Training Program | 645 Cheyenne Blvd, Madison, TN 37115 | 2014-05-06 |
1629497656 | Corey Joseph Cloud | Dentist | 500 Lentz Dr Ste 40, Madison, TN 37115 | 2014-04-07 |
Find all providers in zip 37115 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790343051 | Madison Dental Spa | Clinic/Center | 90 Wall St Ste 100, Madison, CT 06443-3128 | 2019-06-03 |
1306301072 | Dr. Lee Gus Dunker | Clinic/Center | 424 West St, Madison, IN 47250-3302 | 2019-02-06 |
1518422880 | Bright Dental Madison LLC | Clinic/Center | 7866 Mineral Point Rd, Madison, WI 53717-2028 | 2019-01-31 |
1992217053 | Great Day Dental of Monona | Clinic/Center | 2010 Eastwood Dr Ste 206, Madison, WI 53704-5387 | 2017-10-30 |
1770913220 | L.l. Barnett Dental Solutions, P.C. | Clinic/Center | 7185 Highway 72 W Ste C, Madison, AL 35758-6650 | 2013-11-20 |
1114210481 | Abcom Family Dental Care | Clinic/Center | 5402 Mineral Point Rd, Madison, WI 53705-4659 | 2011-05-19 |
1790976553 | Dr Andrew D Friedman Dmd | Clinic/Center | 21 Old Point Ave, Madison, ME 04950-1114 | 2007-08-07 |
1235351750 | Madison Dental Care | Clinic/Center | 535 Gallatin Pike S, Madison, TN 37115-4010 | 2007-05-03 |
1417421421 | Kevin L. Klinedinst Dds PC | Clinic/Center | 110 Miles Ridge Rd, Madison, IN 47250-2410 | 2019-01-14 |
1417476458 | Madison Dental LLC | Clinic/Center | 2110 Fordem Ave, Madison, WI 53704-4610 | 2017-09-11 |
Find all providers in MADISON |
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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.