Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1851372015 Deactivated / Inactive NPI Male Practitioner

Dr. Nathan Dale Willis , DDS

Dentist - General Practice • Bristol, TN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Nathan Willis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 07, 2005
NPI Deactivation Date February 17, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Nathan Willis, DDS was a registered Dentist - General Practice practicing in Bristol, TN. Throughout an active medical career spanning 16 years, Dr. Willis provided care at the practice location at 401 EDGEMONT AVE until profile deactivation on 2021-02-17.

Practice Location & Contact Primary Location

Practice Address

401 Edgemont Ave

Bristol, TN 376202314

Telephone 4899684422
Fax 4239683477

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bristol, TN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.5 Yrs
Regional Practice Density
28 Specialists

Practicing in Bristol, TN (2175 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TN DS0000005035

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. Jason Pittman , DDS

Dentist - General Practice

NPI 1104987171

Doctor of Dental Surgery

Dr. Brandon Roller , DMD

Dentist - General Practice

NPI 1114949294

Doctor of Dental Medicine

Dr. Ronnie Guest , DDS

Dentist - General Practice

NPI 1346225117

Doctor of Dental Surgery

Andrew Mcbride

Dentist - General Practice

NPI 1841616521

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 17, 2021

Record deactivated on February 17, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 401 EDGEMONT AVE, BRISTOL, TN 376202314 (Tel: 4899684422)

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Updated Business Mailing Address July 08, 2007

Registered at 401 EDGEMONT AVE, BRISTOL, TN 376202314 (Tel: 4899684422)

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Provider Name / Credentials Updated July 08, 2007

Recorded as NATHAN WILLIS, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #DS0000005035 in TN)

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Initial NPI Registration & Enumeration November 07, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1851372015
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 07, 2005
Last Update: July 08, 2007
Deactivation Date: February 17, 2021

Mailing Address

401 Edgemont Ave

Bristol, TN 376202314

Phone: 4899684422

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.