=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154306579
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID KIRKLAND ANDREWS DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2005
-----------------------------------------------------
Last Update Date | 01/22/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1412 TROTWOOD AVE STE. 4
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38401-4968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-381-8149
-----------------------------------------------------
Fax | 931-381-6662
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1412 TROTWOOD AVE STE. 4
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38401-4968
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-381-8149
-----------------------------------------------------
Fax | 931-381-6662
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | DS3670
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | DS3670
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------