Healthcare Provider Details

I. General information

NPI: 1013280676
Provider Name (Legal Business Name): ALEC JACOB TEMLOCK DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2012
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 21ST AVE S
NASHVILLE TN
37212-4362
US

IV. Provider business mailing address

4121 ELDER PL
NASHVILLE TN
37215-1732
US

V. Phone/Fax

Practice location:
  • Phone: 615-385-3334
  • Fax: 615-385-3335
Mailing address:
  • Phone: 617-895-8766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number58799
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number12468
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: