Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Pediatric Dentistry of Lebanon, PLLC

Organization Pediatric Dentistry · NPI 1710434204

Pediatric Dentistry of Lebanon, PLLC provides Pediatric Dentistry in Lebanon, Tennessee. Licensed in Tennessee. Registered with an NPI since 2016.

Licensed in
TN
In the registry since
2016
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

103 Physicians Way Ste 150
Lebanon, TN 37090-4132 Not confirmed with CMS for 10 years — call before visiting
Phone: (615) 545-1812
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 8973 (TN)

Record details

NPI number1710434204
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leslie Wallace — Dentist · (615) 545-1812
NPI enumeratedSeptember 1, 2016
Last updated in NPPESSeptember 1, 2016
Mailing address103 Physicians Way, Ste 150, Lebanon, TN 37090-4132

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