Healthcare Provider Details

I. General information

NPI: 1508983636
Provider Name (Legal Business Name): STEVEN EUGENE SYLVESTER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55130 TN-153 STE 125
HIXSON TN
37343
US

IV. Provider business mailing address

142 COUNTY ROAD 193
NIOTA TN
37826-2603
US

V. Phone/Fax

Practice location:
  • Phone: 423-497-1028
  • Fax:
Mailing address:
  • Phone: 423-829-5001
  • Fax: 423-264-2346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12677
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: