Healthcare Provider Details

I. General information

NPI: 1942846795
Provider Name (Legal Business Name): FIREFLY PEDIATRIC DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 STANSBERRY LN STE 105
FRANKLIN TN
37069-5125
US

IV. Provider business mailing address

3000 STANSBERRY LN STE 105
FRANKLIN TN
37069-5125
US

V. Phone/Fax

Practice location:
  • Phone: 615-236-9150
  • Fax: 615-236-9171
Mailing address:
  • Phone: 615-236-9150
  • Fax: 615-236-9171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTIN MICHAEL CHAFIN
Title or Position: OWNER
Credential: DMD
Phone: 615-236-9150