Provider Demographics
NPI:1629203567
Name:ONECARE DENTAL SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ONECARE DENTAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-446-2600
Mailing Address - Street 1:101 W RAILROAD STREET
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1335
Mailing Address - Country:US
Mailing Address - Phone:615-446-2600
Mailing Address - Fax:615-446-3100
Practice Address - Street 1:101 W RAILROAD STREET
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1335
Practice Address - Country:US
Practice Address - Phone:615-446-2600
Practice Address - Fax:615-446-3100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN320594194302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1532557Medicaid