Healthcare Provider Details

I. General information

NPI: 1508080144
Provider Name (Legal Business Name): KRISTEN DARVILLE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 DR DB TODD JR BLVD
NASHVILLE TN
37208-3501
US

IV. Provider business mailing address

510 OLD HICKORY BLVD APT. 205
NASHVILLE TN
37209-5164
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-6910
  • Fax:
Mailing address:
  • Phone: 216-403-7088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2529
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number9272
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: