Healthcare Provider Details

I. General information

NPI: 1811952666
Provider Name (Legal Business Name): PATRICIA J NEWBERRY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3038 NOLENSVILLE ROAD
NASHVILLE TN
37211
US

IV. Provider business mailing address

3038 NOLENSVILLE ROAD
NASHVILLE TN
37211
US

V. Phone/Fax

Practice location:
  • Phone: 615-331-2483
  • Fax: 615-834-7179
Mailing address:
  • Phone: 615-331-2483
  • Fax: 615-834-7179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6845
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: