Healthcare Provider Details

I. General information

NPI: 1073624086
Provider Name (Legal Business Name): JAMES MCGAVOCK FLEMING JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 BLAKEMORE AVE
NASHVILLE TN
37212-3505
US

IV. Provider business mailing address

2125 BLAKEMORE AVE
NASHVILLE TN
37212-3505
US

V. Phone/Fax

Practice location:
  • Phone: 615-383-3690
  • Fax: 615-383-3697
Mailing address:
  • Phone: 615-383-3690
  • Fax: 615-383-3697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7873
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: