=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093179970
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GENX INVESTMENTS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2016
-----------------------------------------------------
Last Update Date | 04/07/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4219 HILLSBORO PIKE STE 100
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37215-3328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-383-4494
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4219 HILLSBORO PIKE STE 100
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37215-3328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-383-4494
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. STANLEY AARON MONTEE
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 931-220-9469
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 8301
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 8290
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------