Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric Dentistry of Lebanon, PLLC

Organization Pediatric Dentistry · NPI 1710434204

Pediatric Dentistry of Lebanon, PLLC is a 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
Phone: (615) 545-1812
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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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