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General NPI Number Information
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NPI Number | 1538298450
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Entity Type | Individual
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Provider Name | GINA ROXANNE PITTENGER D.D.S., M.ED.
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 3712 MIDDLEBROOK PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37921-6503
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Country | US
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Telephone | 865-444-2333
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Fax |
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Provider Business Mailing Address
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Address Line | 200 TECH CENTER DR
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City | KNOXVILLE
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State | TN
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Zip | 37912-2747
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Country | US
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Telephone | 865-637-9711
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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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 | DS0000007274
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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