=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215406368
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAKEYA JENKINS, DDS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/19/2018
-----------------------------------------------------
Last Update Date | 09/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2120 MURFREESBORO PIKE
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37217-3311
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-366-4141
-----------------------------------------------------
Fax | 615-399-9702
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2120 MURFREESBORO PIKE
-----------------------------------------------------
City | NASHVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37217-3311
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 615-366-4141
-----------------------------------------------------
Fax | 615-399-9702
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DENTIST
-----------------------------------------------------
Name | DR. MAKEYA JENKINS
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 615-366-4141
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------