TENNESSEE RIVER DENTAL, PLLC
NPI 1568854875
Clinic/Center - Dental in Hixson, TN
NPI Status: Active since February 23, 2015
Contact Information
4845 HIXSON PIKE STE C
HIXSON, TN
ZIP 37343
Phone: (423) 877-3848
Fax: (423) 877-3726
- Organization
- Clinic/Center
- Dental
- CLIA Number: 44D1035845
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-21-2026
About TENNESSEE RIVER DENTAL, PLLC
This page provides the complete NPI Profile along with additional information for Tennessee River Dental, Pllc, a provider established in Hixson, Tennessee operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1568854875 assigned on February 2015. The practitioner's primary taxonomy code is 261QD0000X with license number 9947 (TN). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Dr. Marcus Kenneth Randall D.m.d. (Owner)
- NPI
- 1568854875
- Provider Name
- TENNESSEE RIVER DENTAL, PLLC
- Entity Type
- Organization
- Location Address
- 4845 HIXSON PIKE STE C HIXSON, TN 37343
- Location Phone
- (423) 877-3848
- Location Fax
- (423) 877-3726
- Mailing Address
- 4845 HIXSON PIKE STE C HIXSON, TN 37343
- Mailing Phone
- (423) 877-3848
- Mailing Fax
- (423) 877-3726
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-23-2015
- Last Update Date
- 02-23-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Dental
- Taxonomy Code
- 261QD0000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 9947
- License State
- TN
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QD0000X | Ambulatory Health Care Facilities | Clinic/Center | 3483 (TN) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 44D1035845
- Facility Type
- Physician Office
- Certificate Effective Date
- February 22, 2024
- Certificate Expiration Date
- February 21, 2026
- Laboratory Director
- DR. STEVEN DRESKIN
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Tennessee River Dental, Pllc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 6 | 8 | 8 | 5 | 4 | 8 | 7 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 12 | 8 | 16 | 5 | 8 | 8 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 2 + 8 + 1 + 6 + 5 + 8 + 8 + 1 + 4 + 24 = 75 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 75 = 5 | 5 | ||||||||
The NPI number 1568854875 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1841317633 | JERRIE JONAKIN RAINES, D.D,S.,PLLC Organization | Dentist (General Practice) | 4845 HIXSON PIKE STE C HIXSON, TN 37343 (423) 877-3848 |
| 1265837108 | JERRIE J RAINES DDS Individual | Dentist | 4845 HIXSON PIKE STE C HIXSON, TN 37343 (423) 877-3848 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568854875, enumerated in the NPI registry as an "organization" on February 23, 2015
The provider is located at 4845 Hixson Pike Ste C Hixson, Tn 37343 and the phone number is (423) 877-3848
This medical organization specializes in Clinic/Center with taxonomy code 261QD0000X with a focus in Dental
The provider's CLIA number is 44D1035845 for a "physician office" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on February 23, 2015. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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