Healthcare Provider Details

I. General information

NPI: 1669016796
Provider Name (Legal Business Name): JOHN JAFARIAN DDS, PERIODONTIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2019
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 MURFREESBORO PIKE
NASHVILLE TN
37217-3314
US

IV. Provider business mailing address

191 S PERKINS RD
MEMPHIS TN
38117-3213
US

V. Phone/Fax

Practice location:
  • Phone: 615-278-6445
  • Fax:
Mailing address:
  • Phone: 615-278-6445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number11173
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number4646
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number11173
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: