TENNESSEE RIVER DENTAL PLLC NPI 1568854875

NPI Information

  • NPI: 1568854875
  • Provider Name: TENNESSEE RIVER DENTAL, PLLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • CLIA Number: 44D0977847
  • Address: 4845 HIXSON PIKE STE C
    HIXSON, TN
    ZIP 37343
  • Phone: (423) 877-3848

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NPI Details

TENNESSEE RIVER DENTAL, PLLC is a dental clinic center in Hixson, TN. TENNESSEE RIVER DENTAL, PLLC NPI is 1568854875. The provider is registered as an organization entity type.

The provider's business location address is:

4845 HIXSON PIKE STE C
HIXSON, TN
ZIP 37343-466
Phone: (423) 877-3848
Fax: (423) 877-3726

The provider's authorized official is Marcus Kenneth Randall .
The authorized official title is Owner and has the following contact phone number (423) 877-3848.

The CLIA number assigned to this NPI record is 44D0977847 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/23/2015 and was last updated on 2/23/2015.

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
1261QD0000XClinic/CenterDental3483TENNESSEENo
2261QD0000XClinic/CenterDental9947TENNESSEEYes

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: 3/30/2025

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