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General NPI Number Information
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NPI Number | 1689236879
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Entity Type | Individual
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Provider Name | MIRISSA PRICE DMD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 3601 THE VANDERBILT CLINIC
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City | NASHVILLE
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State | TN
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Zip | 37232-3501
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Country | US
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Telephone | 615-322-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3841 GREEN HILLS VILLAGE DR STE 200
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City | NASHVILLE
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State | TN
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Zip | 37215-2691
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Country | US
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Telephone |
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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 | DL14012
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11501
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 11501
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 11501
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License Number State | TN
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