Healthcare Provider Details

I. General information

NPI: 1841292737
Provider Name (Legal Business Name): SABIN KANE EWING D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 02/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 PRESIDENT PL STE 210
SMYRNA TN
37167
US

IV. Provider business mailing address

739 PRESIDENT PL STE 210
SMYRNA TN
37167-6844
US

V. Phone/Fax

Practice location:
  • Phone: 615-220-8585
  • Fax:
Mailing address:
  • Phone: 615-220-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7907
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7907
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: