Healthcare Provider Details

I. General information

NPI: 1467908962
Provider Name (Legal Business Name): YEGANEH JEWELL DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5073 MAIN ST STE 240
SPRING HILL TN
37174-2738
US

IV. Provider business mailing address

125 COOL SPRINGS BLVD STE 140
FRANKLIN TN
37067-6475
US

V. Phone/Fax

Practice location:
  • Phone: 615-302-4200
  • Fax:
Mailing address:
  • Phone: 615-771-1111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberS3-293
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number11227
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6836
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: