# LA VERGNE DENTAL ASSOCIATES, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Tennessee Family Dental La Vergne
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356954838
- **Authorized official:** DR. RYAN MARK O'NEILL DMD (OWNER / DENTIST)
- **Authorized official phone:** (615) 280-2667

## Contact information

- **Practice address:** 6001 JACKSON SQUARE BLVD STE 1001, LA VERGNE, TN 37086-2768
- **Practice address phone:** (615) 260-2667
- **Practice address fax:** (615) 280-6615
- **Mailing address:** 6001 JACKSON SQUARE BLVD STE 1001, LA VERGNE, TN 37086-2768
- **Mailing address phone:** (615) 260-2667
- **Mailing address fax:** (615) 280-6615

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/25/2020
- **Last updated:** 08/25/2020