Healthcare Provider Details

I. General information

NPI: 1407774144
Provider Name (Legal Business Name): WILCO DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 TOLLGATE BLVD STE 205
THOMPSONS STATION TN
37179-1005
US

IV. Provider business mailing address

2000 TOLLGATE BLVD STE 205
THOMPSONS STATION TN
37179-1005
US

V. Phone/Fax

Practice location:
  • Phone: 615-538-8204
  • Fax: 615-791-2840
Mailing address:
  • Phone: 615-538-8204
  • Fax: 615-791-2840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHNNA HAYMAN
Title or Position: OWNER/DENTIST
Credential: DMD
Phone: 312-497-3607