Healthcare Provider Details

I. General information

NPI: 1164484085
Provider Name (Legal Business Name): HUEY L NEWBERRY JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 08/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3754 NOLENSVILLE PIKE
NASHVILLE TN
37211-3323
US

IV. Provider business mailing address

3754 NOLENSVILLE PIKE
NASHVILLE TN
37211-3323
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4868
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4868
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: