VISTA RIDGE DENTAL ARTS STUDIO LLC NPI 1154837292

NPI Information

NPI: 1154837292
Provider Name: VISTA RIDGE DENTAL ARTS STUDIO, LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
108 W 10TH AVE
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 979-1800
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VISTA RIDGE DENTAL ARTS STUDIO, LLC is a dental clinic center in Johnson City, TN. VISTA RIDGE DENTAL ARTS STUDIO, LLC NPI is 1154837292. The provider is registered as an organization entity type.

The provider's business location address is:

108 W 10TH AVE
JOHNSON CITY, TN
ZIP 37604-800
Phone: (423) 979-1800
Fax: (423) 979-1802

The provider's authorized official is Amy Herron Moody .
The authorized official title is Dentist/sole Mbr and has the following contact phone number (804) 979-1800.

The enumeration date for this NPI number is 12/27/2017 and was last updated on 12/27/2017.

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
1	261QD0000X	Clinic/Center	Dental	10324	TENNESSEE	Yes

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: 5/5/2024

NPI Synchronization or Removal

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