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General NPI Number Information
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NPI Number | 1164547139
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Entity Type | Individual
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Provider Name | JEAN-MAX JEAN-PIERRE DDS MDS
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 02/07/2020
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Provider Practice Location Address
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Address Line | 100 SPRINGHOUSE CT. SUITE 220
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City | HENDERSONVILLE
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State | TN
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Zip | 37075
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Country | US
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Telephone | 615-264-6404
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Fax | 615-264-0689
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Provider Business Mailing Address
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Address Line | 1779 KIRBY PKWY # 14716
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City | MEMPHIS
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State | TN
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Zip | 38138-3666
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Country | US
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Telephone | 629-777-6455
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DS0000008167
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License Number State | TN
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