Healthcare Provider Details

I. General information

NPI: 1871435065
Provider Name (Legal Business Name): VEOLA THOMAS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 S HIGHLAND ST
MEMPHIS TN
38111-4254
US

IV. Provider business mailing address

3627 SKYLINE DR
KNOXVILLE TN
37914-4720
US

V. Phone/Fax

Practice location:
  • Phone: 313-525-4551
  • Fax:
Mailing address:
  • Phone: 313-525-4551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13170
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6002230-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: