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NPI Code Detail

MEDICARE: DENTAL SPECIALTY EDUCATION, INC

MEDICARE: DENTAL SPECIALTY EDUCATION, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryTN
21223P0106XOral and Maxillofacial Pathology DentistryTN
31223X0400XOrthodontics and Dentofacial Orthopedics DentistryTN
41223P0221XPediatric DentistryTN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11043603996OTHERTNGROUP NPI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043603996
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL SPECIALTY EDUCATION, INC
Provider Business Mailing Address
First Line : 451 MURFREESBORO PIKE
Second Line : BUILDING 1
City : NASHVILLE
State : TN
Zip : 37210-2842
Country : US
Telephone Number : 615-256-7543
Fax Number : 615-256-8895
Provider Business Practice Location Address
First Line : 451 MURFREESBORO PIKE
Second Line : BUILDING 1
City : NASHVILLE
State : TN
Zip : 37210-2842
Country : US
Telephone Number : 615-256-7543
Fax Number : 615-256-8895
Authorized Official
Title or Position : CLINICAL DENTAL DIRECTOR OF SCHOOL
Name : DR. SABIN KANE EWING
Credential : DDS
Telephone Number : 615-256-7543
Provider Enumeration Date : 03/16/2015
Last Update Date : 03/07/2017

Similar Medicare Providers

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1538222583 — DR. JENNIFER GUIDRY D.D.S.
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1497068589 — DR. SAMUEL GONZALO BRICK DDS
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451 MURFREESBORO RD
NASHVILLE, TN
37210-2842
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NASHVILLE, TN
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1255629028 — DENTAL SPECIALISTS OF NASHVILLE, PLLC
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1275895724 — DR. VENETRA JONES D.D.S
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Directions to “DENTAL SPECIALTY EDUCATION, INC ” Practice Location

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