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NPI Code Detail

MEDICARE: ANDREW TANYOUS DDS

MEDICARE: ANDREW TANYOUS DDS
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 Dentistry11914TN

General Provider Information

NPI Number : 1376275362
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW TANYOUS DDS
Provider Business Mailing Address
First Line : 2919 HARDWICK ST
Second Line :
City : MURFREESBORO
State : TN
Zip : 37130-9606
Country : US
Telephone Number : 615-482-1736
Fax Number :
Provider Business Practice Location Address
First Line : 1523 S HIGHLAND AVE
Second Line :
City : JACKSON
State : TN
Zip : 38301-7520
Country : US
Telephone Number : 615-482-1736
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2022
Last Update Date : 06/28/2022

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