Healthcare Provider Details

I. General information

NPI: 1548463466
Provider Name (Legal Business Name): CHILDRENS DENTISTRY OF MURFREESBORO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 10/04/2025
Certification Date: 10/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 OLD FORT PKWY
MURFREESBORO TN
37128-4158
US

IV. Provider business mailing address

2910 OLD FORT PKWY
MURFREESBORO TN
37128-4158
US

V. Phone/Fax

Practice location:
  • Phone: 615-494-5437
  • Fax: 615-494-4649
Mailing address:
  • Phone: 615-494-5437
  • Fax: 615-494-4649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS8406
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH A FAIZ
Title or Position: OWNER/ PEDIATRIC DENTIST
Credential: DDS
Phone: 615-995-4928