NORTH RIVER PERIO PLLC NPI 1477049542

NPI Information

  • NPI: 1477049542
  • Provider Name: NORTH RIVER PERIO PLLC
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • CLIA Number: 44D0885276
  • Address: 5022 OLD GODSEY LN STE 1
    HIXSON, TN
    ZIP 37343
  • Phone: (423) 870-9567

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NPI Details

NORTH RIVER PERIO PLLC is a periodontics dentist in Hixson, TN. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. NORTH RIVER PERIO PLLC NPI is 1477049542. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5022 OLD GODSEY LN STE 1
HIXSON, TN
ZIP 37343-604
Phone: (423) 870-9567
Fax: (423) 870-5331

The provider's authorized official is Rhonda M West .
The authorized official title is Insurance Manager and has the following contact phone number (423) 870-9567.

The CLIA number assigned to this NPI record is 44D0885276 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/2/2018 and was last updated on 7/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodontics7108TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11720292907OTHERTENNESSEECHARLES L MCBRAYER DDS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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