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General NPI Number Information
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NPI Number | 1215649694
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Entity Type | Individual
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Provider Name | KEITA SPAULDING DMD
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Gender | Female
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Dates
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Enumeration Date | 12/19/2022
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Last Update Date | 02/08/2024
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Provider Practice Location Address
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Address Line | 212 INDIAN LAKE BLVD
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-6267
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Country | US
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Telephone | 615-431-3126
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Fax |
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Provider Business Mailing Address
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Address Line | 4018 ASPEN GROVE DR APT 108
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City | FRANKLIN
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State | TN
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Zip | 37067-2983
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Country | US
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Telephone | 615-476-4126
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 10960
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12415
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License Number State | TN
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