Healthcare Provider Details

I. General information

NPI: 1700854858
Provider Name (Legal Business Name): KIM A. SMILEY DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 CLIFTON AVE
NASHVILLE TN
37203-1910
US

IV. Provider business mailing address

138 JOSHUAS RUN
GOODLETTSVILLE TN
37072-3350
US

V. Phone/Fax

Practice location:
  • Phone: 615-321-5600
  • Fax: 615-327-4433
Mailing address:
  • Phone: 615-859-1963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS4871
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: