Healthcare Provider Details

I. General information

NPI: 1356125587
Provider Name (Legal Business Name): BREA NICOLE FLEMING DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9775 US HIGHWAY 64 STE 101
ARLINGTON TN
38002-8587
US

IV. Provider business mailing address

9232 RANDLE VALLEY DR
CORDOVA TN
38018-7725
US

V. Phone/Fax

Practice location:
  • Phone: 901-424-0009
  • Fax:
Mailing address:
  • Phone: 901-828-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12500
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901601798
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: