Healthcare Provider Details

I. General information

NPI: 1306927017
Provider Name (Legal Business Name): DENTACARE OF KNOXVILLE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 KNOXVILLE CENTER DR SUITE 1100
KNOXVILLE TN
37924-5044
US

IV. Provider business mailing address

3001 KNOXVILLE CENTER DR SUITE 1100
KNOXVILLE TN
37924-5044
US

V. Phone/Fax

Practice location:
  • Phone: 865-544-1711
  • Fax: 865-544-1712
Mailing address:
  • Phone: 865-544-1711
  • Fax: 865-544-1712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3265
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number3265
License Number StateTN

VIII. Authorized Official

Name: MS. NANCY F. THOMPSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 865-544-1711