MEDICARE: THOMAS SHAPPLEY UNDERWOOD 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
1	1223G0001X	General Practice Dentistry	DS2193	TN

General Provider Information

NPI Number	:	1700867769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS SHAPPLEY UNDERWOOD DDS

Provider Business Mailing Address
First Line	:	4219 HILLSBORO RD
Second Line	:	STE 105
City	:	NASHVILLE
State	:	TN
Zip	:	37215-3328
Country	:	US
Telephone Number	:	615-383-5366
Fax Number	:	615-386-3360

Provider Business Practice Location Address
First Line	:	4219 HILLSBORO RD
Second Line	:	STE 105
City	:	NASHVILLE
State	:	TN
Zip	:	37215-3328
Country	:	US
Telephone Number	:	615-383-5366
Fax Number	:	615-386-3360

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	03/04/2013

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