CHAMPION DENTISTRY, LLC – NPI #1053946525
Clinic/Center

CHAMPION DENTISTRY, LLC is an AHC clinic located in LEBANON, TN. NPPES has assigned the NPI number 1053946525 to CHAMPION DENTISTRY, LLC on March 05, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHAMPION DENTISTRY, LLC below.

NPI Profile for
CHAMPION DENTISTRY, LLC

NPI Number
1053946525
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHAMPION DENTISTRY, LLC
Primary location
322 N MAPLE ST
LEBANON, TN 37087-2706
Phone: (615) 606-2544 Fax: (888) 752-1480
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DERRICK CHAMPION
OWNER
Phone: (615) 554-7401
Updated
Certification Date
Mar 05, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.