Healthcare Provider Details

I. General information

NPI: 1538780374
Provider Name (Legal Business Name): DAVID LONG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 COOL SPRINGS BLVD STE 260
FRANKLIN TN
37067-6475
US

IV. Provider business mailing address

125 COOL SPRINGS BLVD STE 260
FRANKLIN TN
37067-6475
US

V. Phone/Fax

Practice location:
  • Phone: 615-224-3670
  • Fax: 615-807-1654
Mailing address:
  • Phone: 615-224-3670
  • Fax: 615-807-1654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number11555
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: