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Deactivated NPI 1841416005 Deactivated / Inactive NPI Male Practitioner

Dr. Wayne Benjamin Long , DDS

Dentist - General Practice • Portland, 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. Wayne Long has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 17, 2007
NPI Deactivation Date February 04, 2021
Total Practice Duration ~14 Years of Practice (2007 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Wayne Long, DDS was a registered Dentist - General Practice practicing in Portland, TN. Throughout an active medical career spanning 14 years, Dr. Long provided care at the practice location at 100 MAIN ST until profile deactivation on 2021-02-04.

Practice Location & Contact Primary Location

Practice Address

100 Main St
Suite 105

Portland, TN 371481241

Telephone 6153259690
Fax 6153259690

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Portland, TN

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

Practicing in Portland, 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 DS3074

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.

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 04, 2021

Record deactivated on February 04, 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 100 MAIN ST, SUITE 105, PORTLAND, TN 371481241 (Tel: 6153259690)

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Updated Business Mailing Address July 08, 2007

Registered at 100 MAIN ST, SUITE 105, PORTLAND, TN 371481241 (Tel: 6153259690)

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Provider Name / Credentials Updated July 08, 2007

Recorded as WAYNE LONG, DDS

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

Dentist (License #DS3074 in TN)

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Initial NPI Registration & Enumeration April 17, 2007

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: 1841416005
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 17, 2007
Last Update: July 08, 2007
Deactivation Date: February 04, 2021

Mailing Address

100 Main St, Suite 105

Portland, TN 371481241

Phone: 6153259690

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.