Healthcare Provider Details

I. General information

NPI: 1114716966
Provider Name (Legal Business Name): BELLE MEADE ENDODONTICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 HARDING PIKE STE 202
NASHVILLE TN
37205-2722
US

IV. Provider business mailing address

5115 HARDING PIKE STE 202
NASHVILLE TN
37205-2722
US

V. Phone/Fax

Practice location:
  • Phone: 629-216-3531
  • Fax:
Mailing address:
  • Phone: 629-216-3531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. KATELYN FERGUSON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 615-428-3912