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General NPI Number Information
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NPI Number | 1972680718
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Entity Type | Organization
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Legal Business Name | JIMMY B SHEATS D.D.S., P.C.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1915 CHARLOTTE AVE SUITE 205
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City | NASHVILLE
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State | TN
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Zip | 37203-2130
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Country | US
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Telephone | 615-320-0099
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Fax | 615-825-0006
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Provider Business Mailing Address
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Address Line | 1915 CHARLOTTE AVE SUITE 205
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City | NASHVILLE
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State | TN
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Zip | 37203-2130
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Country | US
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Telephone | 615-320-0099
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Fax | 615-825-0006
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JIMMY B SHEATS
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Credential | D.D.S.
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Telephone | 615-320-0099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2957
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 7716
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 7807
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License Number State | TN
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