Healthcare Provider Details

I. General information

NPI: 1114843497
Provider Name (Legal Business Name): CHRISTIAN GIRARD DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E ANDREW JOHNSON HWY
GREENEVILLE TN
37745-0956
US

IV. Provider business mailing address

3270 OLD STATE ROUTE 34
LIMESTONE TN
37681
US

V. Phone/Fax

Practice location:
  • Phone: 423-278-5019
  • Fax:
Mailing address:
  • Phone: 470-201-0346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13145
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: